Effect of Internet-Based Guided Self-help vs Individual Face-to-Face Treatment on Full or Subsyndromal Binge Eating Disorder in Overweight or Obese Patients

Zwaan, Martina de; Herpertz, Stephan; Zipfel, Stephan; Svaldi, Jennifer; Friederich, Hans‐Christoph; Schmidt, Frauke; Mayr, Andreas; Lam, TH; Schade‐Brittinger, Carmen; Hilbert, Anja

doi:10.1001/jamapsychiatry.2017.2150

Cited by 125 publications

(132 citation statements)

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“…This could be explained by the fact that the IMPULS treatment has addressed BED pathology more comprehensively and promotes a deeper understanding of the mechanisms of the eating pathology, whereas the patients of the control group were only instructed to observe concrete BE episodes and other impulsive behaviours by themselves without getting more background information. This interpretation is in line with De Zwaan et al’s [45] RCT in patients with BED and with Zerwas et al’s [61] RCT in patients with BN, both indicating that a guided online intervention is inferior to a face-to-face intervention. Moreover, it is supported by the result that particularly the DEBQ subscale “external eating” evoked the group difference in the DEBQ: this subscale is addressing the disposition of “eating in response to food-related stimuli” [62, p. 296] or cue reactivity [5], which is precisely what we have targeted in the food cue exposure exercises in the IMPULS treatment.…”

Section: Discussionsupporting

confidence: 85%

“…The sample did show sociodemographic and clinical data that are comparable to other outpatient BED samples, e.g. the sample investigated in the INTERBED trial [45]. The groups did not differ from each other at all assessed variables at baseline.…”

Section: Resultsmentioning

confidence: 74%

“…These results indicate that general impulsivity is a relatively stable trait that is hard to change using a short-term intervention – however, it must be kept in mind that IMPULS was specifically designed to influence impulsive eating behaviour. Concerning BMI, IMPULS was not designed as a weight reduction programme either, and as De Zwaan et al [45] put it, the failure of significant weight loss “may be reinterpreted as stabilization of weight and prevention of further weight gain” (p. 993). Further, it could be useful to make observations in a longer time span as the 3-month follow-up to detect significant changes in BMI and general impulsivity.…”

Section: Discussionmentioning

confidence: 99%

“…the frequency of BE episodes in the past 4 weeks, as well as the abstinence rate [45], the frequency of patients with clinically relevant change (min. 50% reduction of BE episodes in the past 4 weeks) and the deterioration rate (50% increase in BE episodes in the past 4 weeks [46, 47]), the frequency of BE days in the past 4 weeks, and the BE days and episodes in the 2 months before, i.e.…”

Section: Methodsmentioning

confidence: 99%

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IMPULS: Impulsivity-Focused Group Intervention to Reduce Binge Eating Episodes in Patients with Binge Eating Disorder – A Randomised Controlled Trial

Schag¹,

Rennhak²,

Leehr

et al. 2019

Psychother Psychosom

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Background: Impulsivity is a risk factor for binge eating disorder, and binge eating (BE) equates to impulsive eating behaviour. Hence, we developed IMPULS, a cognitive behavioural group intervention focusing on impulsive eating. Methods: We randomised 41 patients to the IMPULS group and 39 to the control group. The IMPULS group participated in the IMPULS treatment, while both groups completed weekly self-observations. We compared both groups concerning BE episodes in the past 4 weeks at the end of treatment (primary outcome). As secondary outcomes, we investigated eating pathology, depression, general impulsivity and body mass index (BMI) at the end of treatment and in a 3-month follow-up. Results: The primary outcome failed, because BE episodes in the past 4 weeks were reduced in both groups at the end of treatment. At follow-up, the IMPULS group showed further improvement, contrary to the control group. The BE days/episodes in the 2 months before were overall reduced in both groups. Eating pathology was reduced in the IMPULS group at the end of treatment and partly in both groups at the follow-up. Depression was only reduced in the IMPULS group. General impulsivity and BMI did not change. Conclusions: The IMPULS study has a negative primary outcome. However, secondary outcomes indicate that the IMPULS treatment might be promising, as BE, eating pathology and depression were reduced in the IMPULS group. The initially reduced BE in the control group might represent a short-term effect from the self-observations. General impulsivity and BMI might need a longer time or more intensive treatment to change.

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Section: Discussionsupporting

confidence: 85%

Section: Resultsmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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IMPULS: Impulsivity-Focused Group Intervention to Reduce Binge Eating Episodes in Patients with Binge Eating Disorder – A Randomised Controlled Trial

Schag¹,

Rennhak²,

Leehr

et al. 2019

Psychother Psychosom

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“…However, as reported with the clinical results of the INTERBED study (de Zwan et al, 2017), a sizable number of screened patients did not meet this criteria. However, as reported with the clinical results of the INTERBED study (de Zwan et al, 2017), a sizable number of screened patients did not meet this criteria.…”

Section: Strengths and Limitationsmentioning

confidence: 93%

Economic evaluation of cognitive behavioral therapy and Internet‐based guided self‐help for binge‐eating disorder

König

Bleibler

Friederich

et al. 2018

Intl J Eating Disorders

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Effectiveness of a Web-Based Cognitive Behavioral Self-Help Intervention for Binge Eating Disorder

Pruessner,

Timm,

Barnow

et al. 2024

JAMA Netw Open

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ImportanceBinge eating disorder (BED) is one of the most frequent eating pathologies and imposes substantial emotional and physical distress, yet insufficient health care resources limit access to specialized treatment. Web-based self-help interventions emerge as a promising solution, offering more accessible care.ObjectiveTo examine the effectiveness of a web-based cognitive behavioral self-help intervention for individuals with BED.Design, Setting, and ParticipantsThis 2-arm, parallel-group randomized clinical trial conducted from January 15, 2021, to August 3, 2022, in Germany and other German-speaking countries enrolled patients aged 18 to 65 years who met the diagnostic criteria for BED (according to the Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]). Data analysis occurred between January 27 and September 4, 2023, following our statistical analysis plan.InterventionsParticipants were randomized to a web-based self-help intervention or a waiting-list control condition.Main Outcomes and MeasuresThe primary outcome was a change in objective binge eating episodes from baseline to after treatment. Secondary outcomes included global eating pathology, clinical impairment, work capacity, well-being, comorbid psychopathology, self-esteem, and emotion regulation.ResultsA total of 1602 patients were screened, of whom 154 (mean [SD] age, 35.93 [10.59] years; 148 female [96.10%]) fulfilled the criteria for BED and were randomized (77 each to the intervention and control groups). The web-based intervention led to significant improvements in binge eating episodes (Cohen d, −0.79 [95% CI, −1.17 to −0.42]; P &lt; .001), global eating psychopathology (Cohen d, −0.71 [95% CI, −1.07 to −0.35]; P &lt; .001), weekly binge eating (Cohen d, −0.49 [95% CI, −0.74 to −0.24]; P &lt; .001), clinical impairment (Cohen d, −0.75 [95% CI, −1.13 to −0.37]; P &lt; .001), well-being (Cohen d, 0.38 [95% CI, 0.01 to 0.75]; P = .047), depression (Cohen d, −0.49 [95% CI, −0.86 to −0.12]; P = .01), anxiety (Cohen d, −0.37 [95% CI, −0.67 to −0.07]; P = .02), self-esteem (Cohen d, 0.36 [95% CI, 0.13 to 0.59]; P = .003), and emotion regulation (difficulties: Cohen d, −0.36 [95% CI, −0.65 to −0.07]; P = .01 and repertoire: Cohen d, 0.52 [95% CI, 0.19 to 0.84]; P = .003).Conclusion and RelevanceIn this randomized clinical trial of a web-based self-help intervention for patients with BED, the findings confirmed its effectiveness in reducing binge eating episodes and improving various mental health outcomes, highlighting a scalable solution to bridge the treatment gap for this condition.Trial RegistrationClinicalTrials.gov Identifier: NCT04876183

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Effect of Internet-Based Guided Self-help vs Individual Face-to-Face Treatment on Full or Subsyndromal Binge Eating Disorder in Overweight or Obese Patients

Abstract: isrctn.org Identifier: ISRCTN40484777 and germanctr.de Identifier: DRKS00000409.

Cited by 125 publications

References 42 publications

IMPULS: Impulsivity-Focused Group Intervention to Reduce Binge Eating Episodes in Patients with Binge Eating Disorder – A Randomised Controlled Trial

IMPULS: Impulsivity-Focused Group Intervention to Reduce Binge Eating Episodes in Patients with Binge Eating Disorder – A Randomised Controlled Trial

Economic evaluation of cognitive behavioral therapy and Internet‐based guided self‐help for binge‐eating disorder

Effectiveness of a Web-Based Cognitive Behavioral Self-Help Intervention for Binge Eating Disorder

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