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Targeting dietary restraint to reduce binge eating: a randomised controlled trial of a blended internet- and smartphone app-based intervention

Published online by Cambridge University Press:  12 July 2021

Jake Linardon ,
Mariel Messer ,
Adrian Shatte ,
David Skvarc ,
John Rosato ,
April Rathgen  and
Matthew Fuller-Tyszkiewicz
Jake Linardon*
Affiliation:
School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
Mariel Messer
Affiliation:
School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
Adrian Shatte
Affiliation:
School of Science, Engineering & Information Technology, Federation University, Melbourne, Australia
David Skvarc
Affiliation:
School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
John Rosato
Affiliation:
School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
April Rathgen
Affiliation:
School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
Matthew Fuller-Tyszkiewicz
Affiliation:
School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia Center for Social and Early Emotional Development, Deakin University, Burwood, Victoria 3125, Australia
*
Author for correspondence: Jake Linardon, E-mail: Jake.linardon@deakin.edu.au
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Abstract

Background

Existing internet-based prevention and treatment programmes for binge eating are composed of multiple distinct modules that are designed to target a broad range of risk or maintaining factors. Such multi-modular programmes (1) may be unnecessarily long for those who do not require a full course of intervention and (2) make it difficult to distinguish those techniques that are effective from those that are redundant. Since dietary restraint is a well-replicated risk and maintaining factor for binge eating, we developed an internet- and app-based intervention composed solely of cognitive-behavioural techniques designed to modify dietary restraint as a mechanism to target binge eating. We tested the efficacy of this combined selective and indicated prevention programme in 403 participants, most of whom were highly symptomatic (90% reported binge eating once per week).

Method

Participants were randomly assigned to the internet intervention (n = 201) or an informational control group (n = 202). The primary outcome was objective binge-eating frequency. Secondary outcomes were indices of dietary restraint, shape, weight, and eating concerns, subjective binge eating, disinhibition, and psychological distress. Analyses were intention-to-treat.

Results

Intervention participants reported greater reductions in objective binge-eating episodes compared to the control group at post-test (small effect size). Significant effects were also observed on each of the secondary outcomes (small to large effect sizes). Improvements were sustained at 8 week follow-up.

Conclusions

Highly focused digital interventions that target one central risk/maintaining factor may be sufficient to induce meaningful change in core eating disorder symptoms.

Keywords

Binge eatingeating disorderse-mental healthpreventionrandomised controlled trialtreatment
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 4 , March 2023 , pp. 1277 - 1287
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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