Objective This study explored consumers' perspectives on self‐monitoring, a common feature in behavioral interventions that helps inform consumers' progress and answer their questions, to learn what outcome metrics matter to consumers and whether self‐selection of these metrics leads to greater engagement (i.e., compliance, satisfaction) in self‐monitoring than monitoring only default options. Methods In a proof‐of‐concept randomized trial, 48 adult participants were randomly assigned to “clinician‐determined monitoring” or “clinician + self‐determined monitoring” conditions. Before starting monitoring, all participants shared outcomes that would matter to them in a mobile intervention for binge eating and weight management. Then, for 3 weeks, participants in the “clinician‐determined” condition monitored their weight and binge‐eating episodes, and participants in the “clinician + self‐determined” condition monitored these and another metric of their choosing. After, satisfaction and compliance were assessed. Results Participants identified 116 metrics, grouped into 12 themes, that mattered to them. During monitoring, participants in the “clinician + self‐determined” condition monitored 41 metrics. Surprisingly, participants in the “clinician‐determined” condition also monitored metrics besides weight and binge eating. This resulted in a failure of our experimental manipulation, which represents a significant limitation of this research. No significant differences emerged in satisfaction or compliance between conditions. Discussion Although our proof‐of‐concept trial yielded null quantitative results, findings also suggested binge eating and weight management interventions may benefit from including an individually customizable monitoring option in addition to default metrics, warranting testing in future research. Public Significance Examining consumers' self‐monitoring preferences for a mobile intervention for binge eating and weight management revealed a variety of metrics that matter to consumers, although binge eating and weight were still most valued. Findings from our proof‐of‐concept trial suggest design implications of encouraging an individually customizable monitoring option, in addition to default metrics, which needs to be tested in future research over a longer period and during actual mobile intervention delivery.

Background People tend to overestimate their expectations for weight loss relative to what is achievable in a typical evidence-based behavioral weight management program, which can impact treatment satisfaction and outcomes. We are engaged in formative research to design a digital intervention that addresses binge eating and weight management; thus, understanding expectations among this group can inform more engaging intervention designs to produce a digital intervention that can achieve greater clinical success. Studies examining weight loss expectations have primarily focused on people who have overweight or obesity. Only one study has investigated weight loss expectations among people with binge eating disorder, a population that frequently experiences elevated weight and shape concerns and often presents to treatment with the goal of losing weight. Objective The aim of the study is to investigate differences in weight loss expectations among people with varying levels of binge eating to inform the design of a digital intervention for binge eating and weight management. Such an evaluation may be crucial for people presenting for a digital intervention, given that engagement and dropout are notable problems for digital behavior change interventions. We tested the hypotheses that (1) people who endorsed some or recurrent binge eating would expect to lose more weight than those who did not endorse binge eating and (2) people who endorsed a more severe versus a low or moderate overvaluation of weight and shape would have higher weight loss expectations. Methods A total of 760 adults (n=504, 66% female; n=441, 58% non-Hispanic White) completed a web-based screening questionnaire. One-way ANOVAs were conducted to explore weight loss expectations for binge eating status as well as overvaluation of shape and weight. Results Weight loss expectations significantly differed by binge eating status. Those who endorsed some and recurrent binge eating expected to lose more weight than those who endorsed no binge eating. Participants with severe overvaluation of weight or shape expected to lose the most weight compared to those with low or moderate levels of overvaluation of weight and shape. Conclusions In the sample, people interested in a study to inform a digital intervention for binge eating and weight management overestimated their expectations for weight loss. Given that weight loss expectations can impact treatment completion and success, it may be important to assess and modify weight loss expectations among people with binge eating prior to enrolling in a digital intervention. Future work should design and test features that can modify these expectations relative to individuals’ intended treatment goals to facilitate engagement and successful outcomes in a digital intervention.

BACKGROUND People tend to overestimate their expectations for weight loss relative to what is achievable in a typical evidence-based behavioral weight management program, which can impact treatment satisfaction and outcomes. We are engaged in formative research to design a digital intervention that addresses binge eating and weight management; thus, understanding expectations among this group can inform more engaging intervention designs to produce a digital intervention that can achieve greater clinical success. Studies examining weight loss expectations have primarily focused on people who have overweight or obesity. Only one study has investigated weight loss expectations among people with binge eating disorder, a population that frequently experiences elevated weight and shape concerns and often presents to treatment with the goal of losing weight. OBJECTIVE The aim of the study is to investigate differences in weight loss expectations among people with varying levels of binge eating to inform the design of a digital intervention for binge eating and weight management. Such an evaluation may be crucial for people presenting for a digital intervention, given that engagement and dropout are notable problems for digital behavior change interventions. We tested the hypotheses that (1) people who endorsed some or recurrent binge eating would expect to lose more weight than those who did not endorse binge eating and (2) people who endorsed a more severe versus a low or moderate overvaluation of weight and shape would have higher weight loss expectations. METHODS A total of 760 adults (n=504, 66% female; n=441, 58% non-Hispanic White) completed a web-based screening questionnaire. One-way ANOVAs were conducted to explore weight loss expectations for binge eating status as well as overvaluation of shape and weight. RESULTS Weight loss expectations significantly differed by binge eating status. Those who endorsed some and recurrent binge eating expected to lose more weight than those who endorsed no binge eating. Participants with severe overvaluation of weight or shape expected to lose the most weight compared to those with low or moderate levels of overvaluation of weight and shape. CONCLUSIONS In the sample, people interested in a study to inform a digital intervention for binge eating and weight management overestimated their expectations for weight loss. Given that weight loss expectations can impact treatment completion and success, it may be important to assess and modify weight loss expectations among people with binge eating prior to enrolling in a digital intervention. Future work should design and test features that can modify these expectations relative to individuals’ intended treatment goals to facilitate engagement and successful outcomes in a digital intervention.

Objective Previous research examining family functioning in eating disorder (ED) treatment has focused primarily on outpatient settings. However, few studies have examined this aspect in partial hospitalization programs. To address this gap, this study examined family functioning over the course of an ED partial hospitalization program (PHP) in adolescent females (M(SD) age = 15.66 (1.50)). Method Participants (n = 105) completed the Family Assessment Device and Eating Disorder Examination Questionnaire at treatment admission, 1‐month post‐admission, and discharge. Results Results from repeated measures analysis of variance indicated adolescents perceived an improvement in family functioning regarding Communication, Affective Responsiveness, and Behavioral Control through 1‐year follow‐up (p values < .05). Neither family functioning at admission nor change in family functioning in the first month correlated with any outcomes (weight, ED symptoms, and remission). Discussion Results support that family functioning does not contribute to ED severity, and that treatment can improve adolescent perception of family functioning. Given the importance of involving the family in ED treatment, identifying mediators of treatment outcomes is critical to improve treatment efficacy. Public Significance Adolescents in a partial hospital program (PHP) for eating disorders (EDs) perceived improvements in their family communication, behavior, and ability to process appropriate emotions from admission to 1‐year post‐treatment, although these aspects did not significantly predict treatment outcomes. The findings provide helpful information for future research on adolescents with EDs in higher levels of care and underscore the importance of exploring mechanisms of family‐based treatment in PHP.