Table 1 Characteristics of included studies
Study | Country | Participants | Mean age, years (SD) | Outcome measures | Low intensity psychological intervention(s) | Comparator(s) | RoB (total/10) |
|---|---|---|---|---|---|---|---|
Jenkins et al.* [54] | UK | N = 126; BN, BED, OSFED; 92.8% female; adults | 30.5 (10.6) | EDE-Q | CBT GSH-F and CBT GSH-E (overcoming binge eating manual); 9 × 25 min sessions; clinical psychologists, qualified nurses with mental health experience (one of who had advanced training in CBT), paraprofessionals | Delayed treatment control | + − + + − (6) |
Lock et al. [38] | USA and Canada | N = 40; AN, 85% female, adolescents | 14.9 (1.81) | %EBW; BMI; EDE | FBT GSH; 12 × 30 min sessions; PhD psychologists, an MD psychiatrist or licensed social workers (all experienced in FBT) | FBT via videoconferencing; 15 × 60 min sessions; Ph.D. psychologists, an MD psychiatrist or licensed social workers (all experienced in FBT) | – – + + –(4) |
Wyssen et al. [55] | Switzerland | N = 63, BED, 87% female, adults | 37.2 (10.4) | Mini-DIPS; EDE-Q; WBQ | Internet-based CBT GSH (BED-Online); 8 sessions; psychotherapists and psychologists in postgraduate training of psychotherapy | Waiting list control | + – + + – (6) |
Carter et al. [56] | Canada | N = 71; BED; 93% female, adults | 40.7 (11.5) | EDE | DBT GSH and DBT USH (the DBT solution for emotional eating manual); DBT GSH 6 × 30 min; DBT GSH clinical psychology graduates | Self-esteem USH (self-esteem: a proven program of cognitive techniques for assessing, improving, and maintaining your self-esteem) | ○ − + + ○ (6) |
Fitzsimmons-Craft et al. [57] | USA | N = 690; BN, BED, purging disorder, unspecified feeding or eating disorder; 100% female; adults | 22.1 (4.9) | EDE-Q | Digital CBT GSH (SB-ED); 2 × 20 min optional telephone calls and asynchronous text-based support (~ 16 messages per participant); psychology doctoral students, social work master’s students, study staff and postdoctoral fellows | Referral to usual care | − + – + + ○ (7/12) |
Hildebrandt et al. [58] | USA | N = 225; BN, BED; 75% female; adults | 41.2 (9.9) | EDE-Q | CBT GSH plus Noom Monitor; 8 × 25 min sessions; certified health coaches | Standard care | − − + + − (4) |
Peterson et al. [59] | USA | N = 112; BED; 82.1% female; adults | 39.7 (13.4) | EDE | CBT GSH (overcoming binge eating manual); 10 × 30 min sessions; master’s level clinician without specialisation in eating disorders | ICAT-BED; 21 × 50 min sessions; doctoral-level psychologists and graduate students | − − + + − (4) |
Cachelin et al. [60] | USA | N = 40; BED; 100% female; adults | 27.0 (8.9) | EDE | CBT GSH (culturally adapted overcoming binge eating manual); 8 × 25 min sessions; graduate- and senior-level undergraduate psychology students | Waiting list control | ○ − + + ○ (6) |
Green et al. [61] | USA | N = 82; AN, BN, BED, OSFED; 100% female; adults | 26.1 (6.1) | EDE-Q | Online dissonance-based program (the Body Project) | Waiting list control | ○ − + + ○ (6) |
de Zwaan et al. [62] | Germany | N = 178; BED; 87.6% female; adults | 43.2 (12.3) | EDE | Internet-based CBT GSH; 2 × 90 min sessions pre- and post-treatment, and weekly email contacts over a 4-month period; coaches | Face-to-face CBT; 20 × 50 min sessions; CBT therapists | − − + + − (4) |
Duarte et al. [49] | Portugal | N = 22; BED; 100% female; adults | 37.7 (7.5) | EDE; BES | CARE USH (manual) | Waiting list control | ○ + + + ○ (8) |
Strandskov et al. [50] | Sweden | N = 92; BN, EDNOS; 96.7% female; adults | 29.1 (9.7) | EDE-Q | Online ACT-influenced CBT program; written feedback on website and phone calls (~ 15 min per week for 8 weeks); clinical psychology master’s students | Waiting list control | ○ − + + ○ (6) |
Kelly and Carter [63] | Canada | N = 31; BED; 83% female; adults | 45.0 (15) | EDE-Q | Behavioural strategies USH and Self-compassion USH | Waiting list control | ○ − + + ○ (6) |
ter Huurne et al. [64] | Netherlands | N = 213; BN, BED, EDNOS; 100% female; adults | 39.4 (11.6) | EDE-Q | Web-based CBT program (Look at your eating); asynchronous internet-based contact; therapists with a bachelor’s degree in nursing or social work or a master’s degree in psychology | Waiting list control | − − + + − (4) |
Grilo et al. [65] | USA | N = 90; BED; 79% female; adults | 45.8 (11.0) | EDE; EDE-Q | CBT USH (overcoming binge eating manual) | Usual care | – − − + ○ (3) |
Masson et al. [66] | Canada | N = 60; BED; 88.3% female; adults | 42.8 (10.5) | EDE; EDE-Q | DBT GSH (DBT for binge eating manual); 6 × 20 min sessions; researcher | Waiting list control | + − + + ○ (7) |
Carrard et al. [67] | Switzerland | N = 74, BED; 100% female; adults | 36.1 (11.4) | EDE-Q; EDI-2; TFEQ | Internet-based CBT GSH (online programme adapted from Overcoming Binge Eating); weekly e-mail contact; psychologists | Waiting list control | + − + + ○ (7) |
Sánchez-Ortiz et al. [68] | UK | N = 76; BN, EDNOS; 98.7% female; adults | 23.9 (5.9) | EDE | Internet-based CBT (overcoming bulimia online), weekly email contact; CBT therapists with eating disorder experience | Delayed treatment control | − − + + ○ (5) |
Traviss et al. [69] | UK | N = 81; BED; 97% female; adults | 36.9 (11.9) | EDE-Q | CBT GSH (working to overcome eating difficulties manual); one 1-h introductory session and 6 × 1 h sessions; trained mental health professionals | Waiting list control | ○ − + + ○ (6) |
Striegel-Moore et al. [70] | USA | N = 123; BN, BED; 91.9% female; adults | 37.2 (7.8) | EDE | CBT GSH (overcoming binge eating manual); one 1-h introductory session and 7 × 25 min sessions; master’s level therapists with no familiarity with eating disorders or treating binge eating | Treatment as usual | ○ − + +○ (6) |
Wilson et al. [71] | USA | N = 205; BED; 85.4% female; adults | 48.3 | EDE | CBT GSH (overcoming binge eating manual); one 1-h introductory session and 9 × 25 min sessions; first- or second-year graduate students with no experience in CBTgsh or treating BED | IPT; one 2-h introductory session and 19 × 60 min sessions and BWL 20 × 50 min sessions; IPT doctoral-level therapists; BWL not included in meta-analysis | ○ − + + ○ (6) |
Schmidt et al. [72] | UK | N = 97; BN, EDNOS; 96.9% female; adults | 27.1 (7.6) | EDE | CD-ROM-based CBT programme (Overcoming Bulimia) | Waiting list control | – − − + ○ (3) |
Steele and Wade [73] | Australia | N = 48; BN, EDNOS, 98.9% female; adults | 26.0 (5.83) | EDE | CBT GSH (bulimia nervosa and binge-eating; 8 × 40 min sessions; postgraduate psychology students | Placebo GSH (Mindfulness-Based Cognitive Therapy for Depression); 8 × 40 min sessions; postgraduate Psychology students Perfectionism GSH (When Perfect Isn’t Good Enough) not included in meta-analysis | ○ − + + ○ (6) |
Ljotsson et al. [74] | Sweden | N = 73; BN, BED; 94.2% female; adults | 34.6 (10.4) | EDE; EDI-2 | CBT GSH (Swedish translation of overcoming binge eating manual); weekly email contact; graduate psychology students | Waiting list control | ○ − + + ○ (6) |
Shapiro et al. [75] | USA | N = 66; BED; 92.4% female; adults | 39.6 (11.7) | QEWP-R; BES | CD-ROM-based CBT programme (based on cognitive-behavioural treatment for healthy weight control); one brief telephone contact per week; research assistant | Group CBT (based on cognitive-behavioural treatment for healthy eating and weight control) and waiting list control; group CBT 10 × 90 min group sessions; group CBT Ph.D. level clinical psychologist | ○ − + + ○ (6) |
Banasiak et al. [76] | Australia | N = 109; BN, 100% female, adults | 28.9 (8.5) | EDE | CBT GSH (Bulimia Nervosa and Binge-Eating: A Guide to Recovery manual); one 1-h introductory session and 9 × 30 min sessions; GPs with no postgraduate or specialist qualification is psychology or psychiatry | Delayed treatment control | – − + + ○ (5) |
Grilo and Masheb [77] | USA | N = 90; BED; 79% female; adults | 46.3 (9.0) | EDE-Q; TFEQ | CBT GSH (overcoming binge eating manual); 6 × 20 min sessions; doctoral research-clinicians trained in CBT and BED | BWL GSH (LEARN Program for Weight Management manual) 6 × 20 min sessions; doctoral research-clinicians trained in CBT and BED; and no treatment manual control not included in meta-analysis | – − + +  ○ (5) |
Bailer et al. [48] | Austria | N = 81; BN; adults | 23.8 (4.5) | EB-IV; EDQ; EDI | CBT GSH (German version of Getting Better Bite by Bite); 18 × 20 min sessions; first- and second-year residents in psychiatry with no experienced with eating disorders or formal psychotherapy training | Group CBT; 18 × 90 min group sessions; experienced therapists | ○ − + + ○ (6) |
Carter et al.* [78] | Canada | N = 72; BED; 100% female; adults | 39.7 (10) | EDE; EDE-Q; EDI | CBT USH (overcoming binge eating manual) | Nonspecific USH (self-assertion for women manual) and waiting list control | – − + + ○ (5) |
Durand and King [79] | UK | N = 68; BN; 100% female; adults | 26.4 (5.85) | BITE; EDE | CBT GSH (Bulimia Nervosa: a guide to recovery manual); regular contact; general practitioners (GPs) | Specialist clinic treatment (combination of CBT and IPT); weekly or fortnightly session; psychiatrists, psychologists, nurse specialists and dietitians | – − + + ○ (5) |
Palmer et al. [80] | UK | N = 121; BN; 96.7% female; adults | 26.9 (8.4) | EDE | CBT GSH-F, CBT GSH-T and CBT SH-MG (overcoming binge eating manual); CBT GSH-F and CBT GSH-T 4 × 30 min sessions, and CBT SH-MG one brief session; nurse therapists experienced in eating disorder treatment | Waiting list control | – − + + ○ (5) |
Carter and Fairburn [81] | UK | N = 72; BED; 100% female; adults | 39.7 (1) | EDE; EDE-Q | CBT GSH and CBT USH (Overcoming Binge Eating manual); CBT GSH 8 × 25 min sessions; non-specialist therapists working in primary care | Waiting list control | – − + + ○ (5) |
Treasure et al.* [82] | UK | N = 81; BN; 100% female; adults | 25.8 (4.18) | EDI; BITE | CBT USH (Getting Better Bite by Bite manual) | CBT and Waiting list control; CBT 16 sessions; CBT therapist | ○ + + + ○ (8) |