Breaking the cycle: a pilot study on autonomous Digital CBTe for recurrent binge eating.

BACKGROUND

Only a minority of people with eating disorders receive evidence-based psychological treatment. This is especially true for those with recurrent binge eating because the shame that accompanies binge eating affects help seeking and there is a shortage of therapists to provide psychological treatments. Digital programme-led interventions have the potential to overcome both barriers.

OBJECTIVE

This study examined the acceptability and effectiveness of a new digital programme-led intervention directly based on enhanced cognitive behaviour therapy (CBT-E), which is an empirically supported psychological treatment for eating disorders.

METHODS

One hundred and ten adults with recurrent binge eating (self-reporting characteristics consistent with binge eating disorder, bulimia nervosa, and similar conditions) were recruited through an advertisement on the website of the UK's national eating disorder charity, . The intervention, called , comprised 12 sessions over 8-12 weeks delivered autonomously (i.e., without external support). Participants completed self-report outcome measures of eating disorder features and secondary impairment at baseline, post-intervention, and 6-month follow-up.

RESULTS

Most participants identified as female, White, and were living in the United Kingdom. Most participants (85%) self-reported features that resembled binge eating disorder, and the rest self-reported features that resembled bulimia nervosa (8%) and atypical bulimia nervosa (7%). On average, participants reported that the onset of their eating disorder was more than twenty years ago. Sixty-three percent of the participants completed (i.e., completed active treatment sessions). Those who completed all sessions and the post-intervention assessment ( = 55, 50%) reported significant decreases in binge eating, eating disorder psychopathology, and secondary impairment at post-intervention. These improvements were maintained at follow-up. Large effect sizes were observed for all these outcomes using a completer analysis and post-intervention data ( = 0.91-1.43). Significant improvements were also observed for all outcomes at post-intervention in the intent-to-treat analysis, with medium-to-large effect sizes.

DISCUSSION

A substantial proportion of those who completed and the post-intervention assessment experienced marked improvements. This provides promising data to support the conduct of a fully powered trial to test the clinical and cost-effectiveness of autonomous .