Abstract
BackgroundBinge Eating Disorder (BED) represents a common eating disorder associated with marked health impairments. A subclinical variant, loss of control eating (LOC) is prevalent in youth. LOC is associated with similar mental distress as full-blown BED, increases the risk to develop a BED and promotes continuous weight gain. The etiology of LOC is not yet fully understood and specialized treatment for youth is scarce.MethodsThe i-BEAT study includes a cross-sectional and longitudinal online questionnaire study (N = 600), an App based daily-life approach and a laboratory virtual reality study in N = 60 youths (14–24 years) with and without LOC as well as a controlled randomized online treatment trial to investigate the feasibility, acceptance and efficacy of a CBT and an interpersonal emotion regulation module for youth (N = 120). The primary outcomes include self-reported as well as measured (heart rate variability, gaze behavior, reaction times in stop signal task) associations between emotion regulation problems (such as dealing with RS), psychological impairment and binge eating in a healthy control group and youth with LOC. Secondary outcomes encompass general eating disorder pathology, social anxiety, body mass index, hyperscanning behavior and therapists’ rating of patients’ condition pre and post treatment. Epigenetic correlates of RS are assessed in healthy controls and youth with LOC and explored before and after treatment.DiscussionThe expected findings will specify the role of interpersonal emotion regulation problems such as coping with the experience of social exclusion and rejection sensitivity (RS) in LOC and clarify, whether including a training to cope with RS adds to the efficacy of a cognitive behavioral treatment (CBT).Trial registration: German Clinical Trial Register: DRKS00023706. Registered 27 November 2020, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023706
Highlights
Introduction of the protagonistsExplanation of the i-BEAT online platformCognitive behavioral treatment (CBT-E)Interpersonal emotion regulation (INTER-E)
A substantial group of youth experiences LOC, defined as loss of control eating over smaller food amounts which do not fulfil the criteria of an objective large food amount as required according to DSM-5, but with equivalent psychopathological relevance [7, 8]
Online self‐help treatment for LOC Based on our previous work in Binge Eating Disorder (BED) in adults [49, 50] and based on our preliminary results of the blended treatment in our pilot BEAT study, we developed an online self-help treatment consisting of two distinct modules cognitive behavioral treatment (CBT)-E and INTER-E
Summary
Introduction of the protagonistsExplanation of the i-BEAT online platformCognitive behavioral treatment (CBT-E)Interpersonal emotion regulation (INTER-E). Identify high-risk situations, plan coping strategies, Evaluation of self-observations with respect to emotion regulation and rejection sensitivity adapt emergency cards. Random occurrence should lead to equal distribution of dropouts in the different groups (LOC vs HCG; CBT-E first vs. Binge Eating Disorder (BED) represents a common eating disorder associated with marked health impairments. Binge eating disorder (BED) and loss of control over eating (LOC) Since the introduction of the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 [1]) in 2013, BED, characterized by recurrent binge eating episodes associated with marked distress represents a separate entity in the section of feeding and eating disorders. Puberty and early adulthood are accompanied by psychological challenges such as striving for autonomy and identity based on the acceptance of appearance and interpersonal competences [5] Most of the research in LOC relies on female participants, even though males are more often affected with BED and LOC than in other EDs [11]
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