Interventions for binge eating disorder in adults with type 2 diabetes: A systematic review

Binge eating disorder frequently co-occurs with type 2 diabetes, creating a dual burden that may complicate both psychological well-being and glycaemic management. Evidence on the effectiveness of health interventions in this population is limited. This systematic review evaluated the effects of health interventions on binge eating outcomes and glycated haemoglobin (HbA1c) among adults with binge eating disorder and type 2 diabetes.

We systematically searched Embase, MEDLINE, APA PsycINFO, CENTRAL, ClinicalTrials.gov and WHO ICTRP in February 2026 for intervention studies evaluating pharmacological, psychological or behavioural interventions. Two reviewers independently screened studies, extracted data and assessed the risk of bias using design-appropriate risk-of-bias tools. Certainty of evidence was evaluated using GRADE.

Two pharmacological studies evaluated glucagon-like peptide-1 receptor agonists (GLP-1RAs), and two psychological studies evaluated cognitive behavioural therapy (CBT) or digitally guided self-help. In the GLP-1RA studies, binge eating outcomes and HbA1c improved during active treatment compared with control, but relapse after treatment discontinuation was reported in one study. CBT was not superior to non-prescriptive therapy, although both groups improved over time. In a single-arm study, guided self-help was associated with within-group improvements in binge eating outcomes. The overall certainty of evidence was very low.

Evidence on the effectiveness of health interventions for adults with binge eating disorder and type 2 diabetes is scarce and of very low certainty. Well-designed, preregistered and adequately powered trials are needed to determine whether targeted interventions can improve both binge eating outcomes and HbA1c in this population.