Providing Online guided Self-help for the management of binge Eating in adults with type 2 Diabetes: The POSE-D pilot study and process evaluation

People with type 2 diabetes (T2D) are more likely to experience binge eating than the generalpopulation, which may interfere with their diabetes management. Guided self-help (GSH) isone of the recommended treatment options for binge eating disorder, but there is currently alack of evidenced treatment for binge eating in individuals living with T2D. The aims of thispilot study were to test the feasibility and acceptability of recruiting and delivering the adapted,online Working to Overcome Eating Difficulties GSH intervention to adults with T2D andbinge eating. The intervention comprises GSH materials presented online in seven sectionsdelivered over 12 weeks, supported by a trained Guide. Twenty-two participants were recruitedin a case series design to receive the intervention and we interviewed four Guides and fiveparticipants afterwards. We measured binge eating, mental wellbeing, quality of life and weightat pre-post and 12-week follow-up. Results showed a significant reduction in binge eating at theend of the intervention, which continued to improve at follow-up. Before the programme, 92 %of participants scored above cut-off for binge eating. This reduced to 41 % post-interventionand no-one at follow-up. These changes were accompanied by significant improvements indepression, anxiety and small changes in eating disorder symptoms. Participants reported making better lifestyle choices, eating more mindfully and having increased self-confidence.The study shows preliminary evidence for online GSH tailored to the needs of individuals with T2D as a feasible and acceptable approach to improving binge eating, diabetes management and mental wellbeing.