| Abstract: | Binge 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.To examine the effectiveness of a web-based cognitive behavioral self-help intervention for individuals with BED.This 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.Participants were randomized to a web-based self-help intervention or a waiting-list control condition.The 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.A 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 < .001), global eating psychopathology (Cohen d, −0.71 [95% CI, −1.07 to −0.35]; P < .001), weekly binge eating (Cohen d, −0.49 [95% CI, −0.74 to −0.24]; P < .001), clinical impairment (Cohen d, −0.75 [95% CI, −1.13 to −0.37]; P < .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).In 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.ClinicalTrials.gov Identifier: NCT04876183 |
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