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

This study aimed to evaluate the effectiveness of a digital self-help intervention based on dialectical behavior therapy (DBT) principles, delivered via a WeChat mini-program, in reducing binge-eating symptoms among Chinese adults.

In a randomized controlled trial, 101 adult females with binge-eating-related disorders (BN, BED, or AN-BP) were randomly assigned to a 4-week DBT-based mini-program or a psychoeducation control. The primary outcome was binge-eating severity (binge eating scale, BES); secondary outcomes included eating disorder psychopathology (EDE-Q), emotion regulation (DERS-16), impulsivity (BIS-11), depression (PHQ-9), and anxiety (GAD-7). Between-group effects were examined from baseline to post-treatment using linear mixed-effects models under the intention-to-treat principle. The intervention group was further followed for 1 and 3 months to assess maintenance of effects. Post-treatment qualitative interviews explored user experience using reflexive thematic analysis.

Compared with the control group, participants in the DBT condition showed a significantly greater reduction in binge-eating severity from baseline to post-treatment (Cohen's d = 1.07, p = 0.013). Both groups demonstrated large within-group improvements in eating disorder cognitions (EDE-Q), while changes in emotion regulation, impulsivity, and mood symptoms were nonsignificant. Within the intervention group, gains in binge-eating and EDE-Q scores were largely maintained at follow-up. Qualitative findings indicated high perceived helpfulness and usability, with feedback emphasizing the program's structured design and practical skills, alongside suggestions for improving efficiency and self-monitoring features.

Findings provide preliminary evidence that Wise Eating is a feasible, scalable, and culturally relevant low-intensity DBT-based intervention for binge eating in China. Future trials should include more diverse samples, longer durations, and enhanced engagement strategies.

ClinicalTrials.gov identifier: NCT07143214.