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Related Experiment Video

Updated: Feb 10, 2026

Author Spotlight: Accessible M&M-Based Mouse Model for Investigating Binge Eating Disorder - Insights into Eating Behaviors, Anxiety, and Neural Mechanisms
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Testing a stepped care model for binge-eating disorder: a two-step randomized controlled trial.

Giorgio A Tasca1, Diana Koszycki2, Agostino Brugnera3

  • 1University of Ottawa, School of Psychology and The Ottawa Hospital Research Institute,Clinical Epidemiology Program, Ottawa,Canada.

Psychological Medicine
|May 25, 2018
PubMed
Summary

A stepped care approach for binge-eating disorder (BED) showed unguided self-help significantly reduced binge eating. A second treatment step did not further improve binge-eating symptoms but did help with interpersonal issues.

Keywords:
Binge-eating disordercognitive-behavioral therapygroup psychotherapystepped careunguided self-help

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Behavioral Science

Background:

  • Binge-eating disorder (BED) is a significant mental health concern.
  • Stepped care models offer sequential treatment intensity for BED.
  • Cognitive-behavioral therapy (CBT) principles inform effective BED interventions.

Purpose of the Study:

  • To evaluate a sequential stepped care model for BED.
  • To compare unguided self-help (USH) with subsequent psychotherapy.
  • To assess the efficacy of group psychodynamic-interpersonal psychotherapy (GPIP) as a second-step treatment.

Main Methods:

  • A two-step randomized controlled trial was conducted.
  • Participants (n=135) initially received USH based on CBT.
  • Remaining participants were randomized to GPIP or a no-treatment control.

Main Results:

  • USH significantly reduced binge-eating frequency and eating disorder cognitions.
  • GPIP did not show additional benefits for binge-eating frequency compared to controls.
  • GPIP significantly improved attachment avoidance and interpersonal problems.

Conclusions:

  • A second step in stepped care did not enhance binge-eating symptom reduction beyond USH.
  • The second step may address underlying factors like attachment and interpersonal issues.
  • Stepped care models require further investigation for optimizing BED treatment.