Randomized controlled trial of an internet-based cognitive-behavioral treatment program for binge-eating disorder
Abstract
Binge-eating disorder (BED) is a prevalent health condition associated with obesity. Few people with BED receive appropriate treatment. Personal barriers include shame, fear of stigma, geographic distance to mental health services, and long wait-lists. The aims of this study were to examine the efficacy of an Internet-based cognitive-behavioral intervention for adults with threshold BED (DSM-IV) and to examine the stability of treatment effects over 12months. Participants were randomly assigned to a 16-week Internet-based cognitive-behavioral intervention (n=69) or a wait-list condition (n=70). Binge-eating frequency and eating disorder psychopathology were measured with the Eating Disorder Examination-Questionnaire and the Eating Disorder Examination administered over the telephone. Additionally, body weight and body mass index, depression, and anxiety were assessed before and immediately after treatment. Three-, 6-, and 12-month follow-up data were recorded in the treatment group. Immediately after the treatment the number of binge-eating episodes showed significant improvement (d=1.02, between group) in the treatment group relative to the wait-list condition. The treatment group had also significantly reduced symptoms of all eating psychopathology outcomes relative to the wait-list condition (0.82≤d≤1.11). In the treatment group significant improvement was still observed for all measures 1year after the intervention relative to pretreatment levels. The Internet-based intervention proved to be efficacious, significantly reducing the number of binge-eating episodes and eating disorder pathology long term. Low-threshold e-health interventions should be further evaluated to improve treatment access for patients suffering from BED.
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A meta-analysis of BED eTherapy programs found moderate pooled reductions in objective binge episode frequency (d = −0.77) and ED psychopathology (d = −0.71) across three studies.
“A meta-analysis of BED eTherapy programs found moderate pooled reductions in objective binge episode frequency (d = −0.77) and ED psychopathology (d = −0.71) across three studies (28–30).”
From The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder (2023) · cites this paper as [29]
Two of the three included studies employed clinical psychologists in the support clinician role, with only one study utilising other health professionals.
“two employed clinical psychologists in the support clinician role (28, 29), with only one study utilising other health professionals (30).”
From The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder (2023) · cites this paper as [29]
All three included studies used superseded DSM-IV diagnostic criteria for BED diagnosis.
“All studies used superseded DSM-IV diagnostic criteria for BED diagnosis in their samples”
From The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder (2023) · cites this paper as [29]
Average post-treatment (2.36) and follow up (2.33) OBE frequency were well below Wagner and colleagues' index for recovery from BED (<4 OBEs).
“In addition, average post (2.36) and follow up (2.33) OBE frequency were well below Wagner and colleagues (29) index for recovery from BED (<4 OBEs).”
From The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder (2023) · cites this paper as [29]
Support sessions with participants were primarily facilitated by trained research assistants, contrasting with previous studies that have employed clinical psychologists in this role.
“Support sessions with participants were primarily facilitated by trained research assistants, contrasting with previous studies that have employed clinical psychologists in this role (28, 29, 60).”
From The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder (2023) · cites this paper as [29]
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- Authors
- Wagner, B., Nagl, M., Dölemeyer, R., Klinitzke, G., Steinig, J., Hilbert, A., & Kersting, A.
- Affiliations
- MSB Medical School Berlin (DE)
- University Hospital Leipzig (DE)
- IFB Adiposity Diseases (DE)
- Leipzig University (DE)
- Corresponding author
- Wagner, Birgit
- Venue
- Behavior Therapy
- Publisher
- Elsevier BV
- Published
- 2016-07
- Volume
- 47
- Issue
- 4
- Pages
- 500-514
- ISSN
- 0005-7894 (ISSN-L)
- OpenAlex
- W2285481096
- Cited by
- 68
- References
- 59
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 7 · 2023: 7 · 2022: 8 · 2021: 8 · 2020: 9 · 2019: 3 · 2018: 4 · 2017: 5 · 2016: 1
- FWCI
- 5.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behavior Therapy (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Bundesministerium für Bildung und Forschung (01EO1001)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- binge eating disorder, internet-based cognitive behavioral therapy, digital health interventions, binge eating frequency, eating disorder psychopathology, treatment efficacy, long-term treatment outcomes, obesity, treatment access barriers, anxiety and depression
- MeSH terms
- Adolescent, Adult, Female, Follow-Up Studies, Humans, Male, Middle Aged, Cognitive Behavioral Therapy, Treatment Outcome, Telemedicine, Internet, Young Adult, Binge-Eating Disorder
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