Self-help Therapy for Teen Binge Eating Disorder

(BEST Trial)

Overseen By Yale Teen Power Study Coordinator

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Yale University

Must not be taking: Weight medications

Disqualifiers: Neurological, Psychotic, Cardiovascular, Diabetes, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 16

Duration: 16 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new self-help therapy for teens experiencing binge eating. It focuses on guided self-help sessions using cognitive behavioral therapy (CBT) techniques to manage and reduce binge eating episodes. Teens participate in weekly online sessions with a therapist and watch brief videos at home to learn and apply these strategies. This trial suits teens who have had at least two binge eating episodes per month over the last three months. As an unphased trial, it offers a unique opportunity for teens to access innovative therapy techniques and contribute to research that could benefit others in the future.

Will I have to stop taking my current medications?

If you are taking medications that could affect your weight or appetite, you may not be eligible to participate in this study.

Will I have to stop taking my current medications?

The trial excludes participants who are taking medications that could influence weight or appetite, so you may need to stop such medications to join the study.

What prior data suggests that this self-help therapy is safe for teens with binge eating disorder?

Research has shown that self-help cognitive behavioral therapy (CBT) can safely treat binge eating disorder. Studies have found that participants generally find web-based guided self-help CBT for binge eating easy to manage. Most people experience only minor side effects, often related to the emotional process of examining their eating habits and thoughts.

In one study, adults using web-based guided self-help reported fewer side effects than those using traditional treatments. This finding suggests that the treatment might also be safe for teenagers. However, individual experiences may vary. Discuss any concerns with the trial team or a healthcare provider. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Unlike traditional treatments for teen binge eating disorder, which often involve in-person therapy sessions, the Binge Eating Self-help for Teens program offers a unique approach by combining guided self-help with online support. Researchers are excited because this method empowers teens to take charge of their recovery through self-monitoring and short, focused video consultations with therapists via a secure platform like Zoom. This format not only makes treatment more accessible and flexible but also integrates technology in a way that could appeal to teens, potentially leading to better engagement and outcomes.

What evidence suggests that this guided self-help CBT is effective for binge eating disorder?

Research has shown that cognitive-behavioral therapy (CBT) effectively treats binge eating disorders. In one study with 154 patients, participants using an online CBT self-help program improved more than those waiting for treatment. Another study found that guided self-help CBT significantly reduced binge eating episodes. This method helps individuals understand and change their eating habits with a therapist's support. In this trial, participants will receive guided self-help CBT specifically designed for teens, which may offer a promising option for addressing binge eating in this age group. ^{1 6 7 8 9}

Who Is on the Research Team?

Janet A Lydecker, PhD

Principal Investigator

Yale University

Are You a Good Fit for This Trial?

This trial is for teens aged 12-17 who are overweight (above the 85th percentile for their age and sex), have had at least two episodes of binge eating per month in the past three months, can read and write English well enough to complete study materials, and can commit to a five-month study. They must be generally healthy without serious medical conditions. Parental consent is required.

Inclusion Criteria

I can read, understand, and write English well enough for study materials.

I can commit to a 5-month study.

My BMI is above the 85th percentile for my age and sex.

Exclusion Criteria

Adolescents will be excluded if they have a concurrent feeding/eating disorder

I am not pregnant or breastfeeding.

I do not have a condition that needs hospital or intensive care.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants receive weekly guided self-help CBT sessions for binge eating over four months

16 weeks

16 visits (virtual)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Binge Eating Self-help for Teens

Trial Overview The trial tests a new guided self-help cognitive-behavioral therapy (CBT) program specifically designed for teens with binge eating issues. It includes one month of monitoring eating behavior followed by four months of weekly guided self-help sessions.

How Is the Trial Designed?

Group I: Binge Eating Self-help for Teens Experimental Treatment 1 Intervention

Participants will have 16 guided self-help sessions (4 months; weekly sessions for adolescents with parents joining monthly). Participants will complete daily self-monitoring of eating behaviors (timing of meals and snacks; whether or not a binge occurred) throughout treatment. Treatment sessions involve a self-help component, which includes brief videos that participants watch at home. Treatment sessions also involve a guidance component (brief consultation), which is 15-30 minutes on a secure videoconferencing platform (e.g., Zoom) between the therapist and the participant. These sessions focus on clarifying material, reviewing self-monitoring and looking for patterns, and problem-solving maladaptive thinking patterns and binge behaviors.

Who Is Running the Clinical Trial?

Yale University

Lead Sponsor

Trials

1,963

Recruited

3,046,000+

Published Research Related to This Trial

A study involving 123 individuals showed that a manual-based guided self-help form of cognitive behavioral therapy (CBT-GSH) was more effective than treatment as usual (TAU) in achieving abstinence from binge eating, with 64.2% of participants in the CBT-GSH group achieving this compared to 44.6% in the TAU group at the 12-month follow-up.

CBT-GSH also led to significant improvements in various secondary outcomes, including dietary restraint, concerns about eating, shape, and weight, as well as reductions in depression and better social adjustment, making it a strong first-line treatment for those with recurrent binge eating.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive behavioral guided self-help for the treatment of recurrent binge eating. Striegel-Moore, RH., Wilson, GT., DeBar, L., et al.[2021]

Dialectical Behavior Therapy (DBT) is an effective evidence-based treatment for binge-eating disorder (BED), which is a serious public health issue characterized by recurrent binge eating without extreme weight control behaviors.

Self-help versions of DBT for BED could increase access to treatment by being less time-consuming and costly, making it a promising alternative to traditional therapy, especially in areas with limited access to specialized providers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dialectical behavior therapy guided self-help for binge-eating disorder. Kenny, TE., Carter, JC., Safer, DL.[2020]

Both therapist-guided and unguided cognitive behavioral self-help methods are effective for treating binge eating, as shown in a study with 40 women, most of whom had binge eating disorder.

The guided self-help approach was more effective in reducing binge eating episodes and associated symptoms, highlighting the importance of support in treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Guided and unguided self-help for binge eating. Loeb, KL., Wilson, GT., Gilbert, JS., et al.[2019]

In a study of 278 patients with binge-eating disorder (BED), web-based guided self-help cognitive behavioral therapy-enhanced (CBT-E) led to a significant reduction in binge-eating episodes, from an average of 16 episodes per 4 weeks to just 5 episodes during the last 4 weeks of treatment.

30% of participants achieved abstinence from binge eating, and 28% reported full recovery, indicating that guided self-help CBT-E is effective in real-world clinical settings, with large effect sizes for all outcome measures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of web-based guided self-help cognitive behavioral therapy-enhanced for binge-eating disorder: An implementation study. Melisse, B., van den Berg, E., de Beurs, E.[2023]

In a study involving 72 women with binge eating disorder, both pure self-help (PSH) and guided self-help (GSH) methods significantly reduced binge eating, with nearly half of the participants stopping binge eating altogether after 12 weeks.

The effectiveness of these self-help programs was sustained over a 6-month follow-up, suggesting that cognitive-behavioral self-help can be a valuable initial treatment and a preventive measure for binge eating disorder.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive-behavioral self-help for binge eating disorder: a controlled effectiveness study. Carter, JC., Fairburn, CG.[2022]

Guided self-help cognitive behavioral therapy-enhanced (CBT-E) significantly reduced binge eating episodes from an average of 19 to 3 binges over 12 weeks, with 40% of participants achieving full recovery, indicating its efficacy as a treatment for binge eating disorder.

The study involved 180 patients in a randomized controlled trial, and while the guided self-help CBT-E group showed superior results initially, both groups had similar outcomes at follow-up after receiving treatment, highlighting the importance of access to timely care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of Web-Based, Guided Self-help Cognitive Behavioral Therapy-Enhanced for Binge Eating Disorder: Randomized Controlled Trial. Melisse, B., Berg, EVD., Jonge, M., et al.[2023]

Citations

1. nationaleatingdisorders.org nationaleatingdisorders.org/

NEDA | Eating Disorders Support, Awareness & Recovery Access support, explore resources, join community events, and take a free eating disorders screening—start your recovery journey with NEDA!

2. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2818753

Web-Based Cognitive Behavioral Self-Help Intervention for ... In this randomized clinical trial involving 154 patients with BED, access to a web-based cognitive behavioral self-help intervention was superior to a waiting- ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2880824/

Cognitive-Behavioral Guided Self-Help for the Treatment ... Despite proven efficacy of cognitive-behavioral therapy (CBT) for treating eating disorders with binge eating as the core symptom, few patients receive CBT ...

4. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/10.1002/eat.24079

Effectiveness of web‐based guided self‐help cognitive ... Cognitive behavioral therapy-enhanced (CBT-E) (Fairburn, 2008) is one of the recommended evidence-based treatment for eating disorders (EDs) ( ...

5. jmir.org jmir.org/2023/1/e40472/

Efficacy of Web-Based, Guided Self-help Cognitive ... Efficacy of Web-Based, Guided Self-help Cognitive Behavioral Therapy–Enhanced for Binge Eating Disorder: Randomized Controlled Trial

6. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2839931

Web-Based Guided Self-Help vs Treatment as Usual for ... This randomized clinical trial of adults with binge-eating disorder assesses whether web-based guided self-help is noninferior to treatment ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10186189/

Efficacy of Web-Based, Guided Self-help Cognitive Behavioral ... Owing to the gap between treatment supply and demand, there are long waiting periods for patients with binge eating disorder, and there is an urgent need to ...

8. clinicaltrials.gov clinicaltrials.gov/study/NCT06107387

Binge Eating Self-help for Teens ONLINE Pilot and ... Details for study NCT06107387, | ClinicalTrials.gov.

9. frontiersin.org frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1332360/full

Web-based guided self-help cognitive behavioral therapy– ... Binge-eating disorder (BED) is a psychiatric disorder characterized by recurrent episodes of eating a large amount of food in a discrete period of time ...