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Reduced exposure to social reward during the COVID‐19 pandemic may result in both reduced reward response to day‐to‐day life activities and elevated reward response to substances or naturally rewarding stimuli (e.g., food). The combined hypo‐ and hyper‐reward responses results in a reward imbalance, which has been noted as a relevant maintenance factor for eating disorders (EDs) characterized by binge eating. This registered report describes the protocol for a pilot randomized controlled trial (RCT) comparing supportive therapy to a novel treatment targeting reward imbalance (Reward Re‐Training; RRT) for individuals with binge eating. Aims of the current study include to confirm feasibility and acceptability of RRT, to evaluate the ability of RRT to engage critical targets, and to provide preliminary estimates of efficacy in reducing ED symptoms at both posttreatment and 3‐month follow‐up. Sixty participants will be randomized to either RRT or supportive therapy. For both conditions, treatment will be delivered in 10 weekly group outpatient therapy sessions conducted remotely using videoconferencing software. Assessments will be conducted at baseline, mid‐treatment, posttreatment, and 3‐month follow‐up to measure feasibility, acceptability, critical treatment targets (i.e., reward to day‐to‐day life activities, reward to palatable foods, social isolation, and loneliness), and ED symptoms.

ObjectiveLow participation and retention rates are persistent problems in eating disorder (ED) research. In order to improve the research process, this study used a qualitative approach to examine factors promoting and limiting research study participation among patients with EDs, and their preferences during research.MethodFive 90‐min focus groups were conducted with adult women (N = 29) enrolled at a residential ED treatment facility. Facilitators asked a series of open‐ended questions about participants' experiences, opinions, and preferences with regard to ED treatment research. Transcript analysis identified themes using a consensual qualitative research approach.ResultsIt was revealed that preventing others' suffering, improving ED treatment, and having low participant burden were major themes facilitating research participation. Major barriers to research participation included concern that research interferes with self‐care/recovery, burdensome nature of study design, and demeanor of the researchers/institutions involved with the study. Patients believed that the format of research assessments could be improved by better assessing the nuances of ED behaviors, examining non‐ED outcomes, and including more open‐ended questions. Patients anticipated that challenges in recovery, feelings of guilt, and logistical barriers could interfere with their ability to complete follow‐up research assessments.DiscussionFactors related to the recruitment process, assessment format, follow‐up methods, and communication throughout the research process may need to be addressed to increase participation and retention rates. Findings indicate that recruitment strategies should include emphasizing the broader impact of the research and increasing sensitivity to the nature of patients with EDs experiences.

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Outcomes from cognitive behavioral therapy for binge‐eating spectrum disorders are suboptimal, possibly due in part to deficits in self‐regulation (i.e., the ability to control behavior in pursuit of long‐term goals despite internal challenges). Mindfulness and acceptance‐based treatments (MABTs) integrate behavioral treatment with psychological strategies designed to enhance self‐regulation, yet little is known about how and for whom they are effective. The present study will utilize the multiphase optimization strategy to identify which of four MABT components (mindful awareness, distress tolerance, emotion modulation, values‐based decision making) to include in a fully powered clinical trial. Participants (n = 256) will be randomized to 16 sessions in one of 16 conditions, each a different combination of MABT components being included or excluded from a base behavioral treatment. Our primary aim is to evaluate each component's independent efficacy on disordered eating symptoms. Our secondary aims are to confirm each component's target engagement (i.e., whether each component improves the targeted variable and outcomes), and test that each component's efficacy is moderated by baseline weaknesses in the same component (e.g., that participants with poor distress tolerance at baseline benefit most from the distress tolerance component). Our exploratory aim is to quantify the component interaction effects.