Wise Eating: A Guided Dialectical Behavior Therapy-Based APP for Binge Eating-A Randomized Controlled Trial

Area of Science:

• Psychiatry
• Digital Health
• Behavioral Therapy

Background:

• Binge eating is a significant concern among adults.
• Digital interventions offer scalable solutions for mental health challenges.
• Dialectical Behavior Therapy (DBT) principles have shown promise in treating eating disorders.

Purpose of the Study:

• To evaluate the effectiveness of a digital self-help intervention based on DBT principles for reducing binge-eating symptoms.
• To assess the intervention's impact on eating disorder psychopathology, emotion regulation, impulsivity, depression, and anxiety.
• To explore user experience and perceived helpfulness of the digital intervention.

Main Methods:

• A randomized controlled trial involving 101 adult females with binge-eating-related disorders.
• Participants were assigned to a 4-week DBT-based WeChat mini-program or a psychoeducation control group.
• Primary outcome: binge-eating severity (BES). Secondary outcomes: EDE-Q, DERS-16, BIS-11, PHQ-9, GAD-7. Follow-up at 1 and 3 months.

Main Results:

• The DBT intervention group showed significantly greater reductions in binge-eating severity compared to the control group (Cohen's d = 1.07, p = 0.013).
• Both groups improved in eating disorder cognitions, but emotion regulation, impulsivity, and mood symptoms did not significantly change.
• Intervention effects on binge-eating and EDE-Q were maintained at 1 and 3-month follow-ups. Qualitative data indicated high usability and perceived helpfulness.

Conclusions:

• The "Wise Eating" program, a low-intensity DBT-based intervention delivered via WeChat, is a feasible, scalable, and culturally relevant option for binge eating in China.
• Preliminary evidence supports its effectiveness in reducing binge-eating severity.
• Future research should focus on diverse samples, longer intervention durations, and enhanced engagement strategies.