Table 4 Summary of findings for psychological interventions in BED and LOC eating in children and adolescents from included studies

RCTs

Hilbert et al. (2019) [Germany]

RCT

WL

15.3

73

BED

Individual

20

4 months

EDE

EDE

Treatment drop out (< 10 sessions attended):

Individual CBT

(2.5, nr)

F:82

CBT

[N]

BE episodes:

BE episodes:

0.35**

9/37 (24%) [CBT]

(n = 37) vs

E: nr

[OP]

11.8 (9.8) [CBT]

1.3 (3.1) [CBT]

14/36 (39%) [WL]

WL (n = 36)

11.2 (8.9) [WL]

6 (8.6) [WL]

Follow-up at 6, 12, 24 months, ITT analyses:

OBE episodes:

OBE episodes:

0.38***

BE episodes: F (6, 284): 46.3***

7.9 (9.6) [CBT]

0.5 (1.7) [CBT]

OBE episodes: F (6, 283): 31.0***

7.4 (7.4) [WL]

3.6 (5.2) [WL]

GEDP: F (6, 267): 36.4***

GEDP:

GEDP:

BDI-II: F (6, 260): 13.3***

2.3 (0.9) [CBT]

1.4 (0.9) [CBT]

0.34*

RSES: F (6, 257): 12.9***

2.2 (0.8) [WL]

2.0 (0.9) [WL]

SF12-MQL: F (6, 242): 8.3***

BDI-II:

BDI-II:

14.3 (11.1) [CBT]

12.2 (14.0) [CBT]

-0.05

15.6 (10.1) [WL]

11.9 (10.9) [WL]

RSES:

RSES:

28.1 (7.0) [CBT]

28.9 (9.3) [CBT]

0.02

27.1 (5.6) [WL]

27.9 (8.3) [WL]

SF12-MQL:

SF12-MQL:

44.4 (13.8) [CBT]

45.9 (15.7) [CBT]

0.08

42.6 (14.2) [WL]

42.6 (15.3) [WL]

-

Absence from BE:

-

19 (51) [CBT]

0.61*

12 (33) [WL]

Remission from BED:

21 (57) [CBT]

0.67*

12 (33) [WL]

Jones et al. (2010) [USA]

RCT

WL

SB2-BED

Total: 105

 ≥ 85th percentile for age adjusted BMI

Individual internet facilitated semi structured programme based on CBT

16

16 weeks

Binge eating

Binge eating

nr

16 (8 (15%) from each group) lost to follow-up at 3 months

Internet facilitated intervention ‘StudentBodies2-BED’ (n = 52) vs

15.0

SB2-BED

Subthreshold BED

[OP]

[N]

OBEs/SBEs:

OBEs/SBEs:

Binge eating

WL (n = 53)

(1.0, nr)

52

18.37 (22.63) [SB2-BED]

7.44 (17.89) [SB2-BED]

OBEs/SBEs:

WL

F:73

8.27 (17.75) [WL]

6.16 (16.10) [WL]

9.0 (19.45) [SB2-BED]

15.2

E: 67

OOEs:

OOEs:

3.20 (8.92)* [WL]

(1.1, nr)

WL

8.75 (15.0) [SB2-BED]

3.98 (11.25) [SB2-BED]

OOEs:

53

7.78 (13.89) [WL]

3.63 (7.14) [WL]

3.69 (11.68) [SB2-BED]

F: 66

Weight and shape concerns

Mann Whitney U (U81): 565**

1.43 (0.92) [WL]

E: 60

1.38 (0.84) [SB2-BED]

Weight and shape concerns

Mann Whitney U (U84): 562.5* (baseline to follow-up)

1.43 (0.92) [WL]

1.10 (0.72) [SB2-BED]

Weight and shape concerns

Depressed mood

1.24 (0.76) [WL]

1.0 (8.2) [SB2-BED]

16.62 (10.26) [SB2-BED]

Depressed mood

1.25 (0.77) [WL]

15.94 (10.49) [WL]

11.29 (9.76) [SB2-BED]

Depressed mood

13.22 (10.79) [WL]

12.35 (11.57) [SB2-BED]

11.16 (11.05) [WL]

Mazzeo et al. (2016) [USA]

RCT

Weight management group 2Bfit

LIBER8

F:100

BED or

DBT based group intervention

Wave 1 = 12

Wave 1: 12 weeks

EDE-Q

EDE-Q

nr

Drop outs:

DBT style intervention LIBER8

15.50 (1.64,nr)

E: 44

LOC eating

subsequent waves = 8

Subsequent waves: 8 weeks

Eating concern

Eating concern

Post test (10, 36% [LIBER8], 4, 24% [2Bfit]

(n = 28)

2Bfit

[N]

1.92 (nr) [LIBER8]

1.05 (nr)* [LIBER8]

3 months (16, 57% [LIBER8], 6, 35% [2Bfit]

Or weight management 2Bfit (n = 17)

15.29 (1.90, nr)

1.90 (nr) [2BFit]

0.70 (nr)* [2BFit]

3 month follow-up data not reported

For 3/5 waves

Shape concern

Shape concern

3.32 (nr) [LIBER8]

2.44 (nr)* [LIBER8]

2.88 (nr) [2BFit]

1.76 (nr)** [2BFit]

Weight concern

Weight concern

3.33 (nr) [LIBER8]

2.72 (nr)* [LIBER8]

2.96 (nr) [2BFit]

2.13 (nr)** [2BFit]

Restraint

Restraint

1.54 (nr) [LIBER8]

1.00 (nr)* [LIBER8]

1.65 (nr) [2BFit]

1.20 (nr)* [2BFit]

Total

Total

2.53(nr) [LIBER8]

1.74 (nr)* [LIBER8]

2.24 (nr) [2BFit]

1.37 (nr)** [2BFit]

EES-C

EES-C

Anxiety, anger, frustration

Anxiety, anger, frustration

0.91 (nr) [LIBER8]

0.82 (nr) [LIBER8]

1.14 (nr) [2BFit]

0.68 (nr)* [2BFit]

Depressive sx

Depressive sx

1.71 (nr) [LIBER8]

1.38 (nr) [LIBER8]

2.10 (nr) [2BFit]

1.62 (nr)** [2BFit]

Feeling unsettled

Feeling unsettled

1.28 (nr) [LIBER8]

0.87 (nr) [LIBER8]

1.32 (nr) [2BFit]

1.04 (nr) [2BFit]

EAH

EAH

Negative affect

Negative affect

1.07 (nr) [LIBER8]

0.87 (nr)** [LIBER8]

1.24 (nr) [2BFit]

0.90 (nr) [2BFit]

External

External

2.15 (nr) [LIBER8]

2.10 (nr) [LIBER8]

2.15 (nr) [2BFit]

2.04 (nr) [2BFit]

Fatigue

Fatigue

1.65 (nr) [LIBER8]

1.54 (nr) [LIBER8]

1.87 (nr) [2BFit]

1.46 (nr) [2BFit]

Mehlenbeck et al. (2009) [USA]

RCT

n/a

Study 1

Study 1

Overweight

Study 1 + 2 CBT + PEAT/CBT + EXER

16

Study 1 + 2

BES

BES

nr

Study 1

Study 1

14.51

76

subthreshold BED

CBT was group focused

[Y]

16 week intervention

(12.22, 7.60) [study 1]

F (1, 60): 9.43** [study 1]

18% dropped out before completion

(CBT + PEAT vs CBT + EXER)

(0.93, 13–16)

F: 71.1

[OP]

(11.34, 7.50) [study 2]

F (1, 98): 20.98** [study 2]

Study 2

Focused on dietary exchanges

Study 2

E: 78.9

Correlation

Correlation

15% dropped out before completion

Study 2

14.33 (0.99, 13–16)

Study 2

SPP social acceptance

SPP social acceptance

No follow-up in either study

(CBT + PEAT vs

118

-.191 [study 1]

.085 [study 1]

CBT + EXER)

F: 68.1

-.139 [study 2]

.165 [study 2]

Focused on calorie restriction

E: 78.0

SPP athletic competence

SPP athletic competence

-.445** [study 1]

.285** [study 1]

.025 [study 2]

-.019 [study 2]

SPP physical appearance

SPP physical appearance

-.428** [study 1]

.404** [study 1]

-.424** [study 2]

.277** [study 2]

SPP global self worth

SPP global self worth

-.482** [study 1]

.421** [study 1]

-.504** [study 2]

.300** [study 2]

Physical self worth

Physical self worth

-.411** [study 1]

.415** [study 1]

-.310** [study 2]

.199* [study 2]

Saravi et al. (2020), [Iran]

Quasi experimental RCT

WL

Group schema therapy

30

Score 17 or above on BE scale

Group schema therapy

13

13 weeks

SR

SR

Drops outs: nr

Group schema therapy (n = 15) vs WL (n = 15)

15.47

F:100

BMI of 25–29.9

[N]

GS: 208.73 (28.779)

GS: 269.20 (27.857)

Follow-up at 3 months

(nr, 15–17)

E: nr

Control: 200.40 (29.722)

Control: 199.80 (29.979)

SR

WL

EA

EA

GS: 268.07 (28.106)

15.53

GS: 20.60 (6.895)

GS: 13.93 (6.681)

Control: 199.80 (29.881)

(nr, 15–17)

Control: 23.67 (9.832)

Control: 23.80 (9.937)

EA

Repeated measures analysis of variance

GS: 14.20 (8.906)

Time:

Control: 23.60 (9.311)

Self regulation F 114.65*

0.804

Eating attitude F 15.80*

0.361

Time Group:

Self regulation F 116.30*

0.804

Eating attitude F16.18*

0.366

Shomaker et al. (2017) [USA]

RC pilot trial

Family based health education (FB-HE)

FB-IPT

Total: 29

BMI ≥ 85th percentile

Family based interpersonal psychotherapy (parent child dyads)

12

12 weeks

Social problems

Changes post intervention:

Drop outs:

FB-IPT (n = 15) vs FB-HE (n = 14)

11.7 (1.6, 9.2–13.4)

FB-IPT

 ≥ 1 LOC eating episode in a month

[Y]

1.6 (0.3) [FB-IPT]

Δ Social problems

0.30

Post treatment (27% [FB-IPT], 14% [FB-HE])

FB-HE

15

1.6 (0.4) [FB-HE]

0.01 [FB-IPT], 0.20 [FB-HE]

6 months (40% [FB-IPT], 36% [FB-HE])

11.0 (1.9, 8.4–13.5)

F: 46.7

Depression symptoms

Δ Depression

1 year (53% [FB-IPT], 43% [FB-HE])

E: 20.0

7.0 (4.1) [FB-IPT]

-3.96 [FB-IPT], 0.66 [FB-HE]

1.23**

6 months

FB-HE

8.4 (4.8) [FB-HE]

Δ Anxiety

Δ Social problems -0.11 [FB-IPT], 0.18 [FB-HE]

14

Anxiety symptoms

-3.64 [FB-IPT], -0.25 [FB-HE]

0.79**

Δ Depression -3.33 [FB-IPT], -2.27 [FB-HE]

F:78.6

30.8 (5.9) [FB-IPT]

Δ Anxiety –6.07 [FB-IPT], -0.42 [FB-HE]

E:21.4

34.7 (5.9) [FB-HE]

Δ disordered eating -0.82 [FB-IPT], -0.43 [FB-HE]

LOC episodes, past month

12 months

3.1 (1.8) [FB-IPT]

Δ Social problems -0.16 [FB-IPT], -0.10 [FB-HE]

2.6 (1.4) [FB-HE]

Δ Depression -4.42 [FB-IPT], -0.20 [FB-HE]

Δ Anxiety 2.97 [FB-IPT], -4.61 [FB-HE]

Δ disordered eating -0.92 [FB-IPT], -0.91 [FB-HE]

Tanofsky-Kraff et al. (2014)

RCT

HE

14.5

Total: 113

High risk of obesity (BMI: 75th- 97th percentile)

Group adapted interpersonal psychotherapy

1.5 h individual session

12 weeks

LOC episodes

Reported graphically so unable to tabulate

nr

Drop out after:

[USA]

IPT (n = 55) vs HE (n = 58)

(1.7, 12–17)

IPT

LOC eating

12 group sessions

4.7 (nr) [IPT]

12 weeks (3, 5.5% [IPT], 5, 8.6% [HE])

55

Not BED

[N]

8.0 (nr) [HE]

6 months (4, 7.2% [IPT], 6, 10.3% [HE])

F: 100

32.7% reported BE

Binge episodes

12 months (6, 10.9% [IPT], 9, 15.5% [HE])

E: 52.7

0.4 (nr) [IPT]

12 months

HE

0.8 (nr) [HE]

Binge episodes

58

Depressive symptoms

0.4 (SE = 0.00, 0.09) [IPT]

F:100

10.1 (6.9) [IPT]

0.16 (SE = 0.14, 0.23) [HE] *

E:60.3

11.2 (6.3) [HE]

LOC episodes:

Anxiety symptoms

F (3, 310) = 78.33***, No group by interval effect

33.3 (7.1) [IPT]

Depressive symptoms

34.9 (6.3) [HE]

F (3, 315) = 37.54***, No group/group by interval effect

Anxiety symptoms

F (3, 311) = 9.06***, No group/group by interval effect

Tanofsky-Kraff et al. (2016) [USA]CASE

RCT

HE

IPT 14.1 (1.5, nr)

IPT

BMI between 75 and 95th percentiles

Group adapted interpersonal psychotherapy

1.5 h individual session

12 weeks

Pre meal BRUMS (mean, SE)

Followed up at 6 months and 1 year

nr

4% dropped out before test meal at baseline

IPT (n = 46)

HE 14.7

46

LOC eating in the past month

12 group sessions

Anger

22% dropped out before final follow-up

vs HE (n = 42)

(1.8, nr)

F: 100

[N]

45.8 (0.8) [IPT]

Pre meal BRUMS 6 months, 1 year (mean, SE)

E: 24

46.2 (0.8) [HE]

Anger

HE

Depression

45.3 (0.5), 44.3 (0.2) [IPT]

42

44.9 (0.4) [IPT]

45.6 (0.6), 45.4 (0.5) [HE]

F:100

45.5 (0.5) [HE]

Depression

E: 22

Tension

44.5 (0.2), 44.2 (0.1) [IPT]

45.3 (0.7) [IPT]

44.3 (0.1), 45.5 (0.6) [HE]

45.3 (0.8) [HE]

Tension

44.0 (0.6), 42.5 (0.4) [IPT]

45.1 (0.9), 44.3 (0.8) [HE]

Case series

Guerdjikova et al. (2019) [USA]

Retrospective chart review

n/a

16.5

25

BED

Medication (LDX)

n/a

19.1 months (mean)

Mean maximum dose of LDX 58.0 mg/d (SD 15 mg/d)

Complete remission of symptoms (16%)

nr

No follow-up

(nr, 10–19)

F:72

[N]

13.8 (SD)

36% received concurrent psychotherapy for BED whilst on LDX

Reduction in binge eating frequency/improvement in

E: nr

12% also on aripiprazole

binge eating symptoms (24%)

Likely to binge if LDX skipped (8%)

Less frequent sneaking of food (4%)

Binge eating occasionally in response to increased stress (8%)

No response (16%)

Worsening of BED symptoms (8%)

No description of response (16%)

Kamody et al. (2019) [USA]

pilot trial

n/a

15.4 (1.30, 14–18)

15

Subthreshold BED

Condensed DBT skills group

10

10 weeks

Met criteria for BED: 6/15, 40%

Met criteria for BED: 3/15, 20%

nr

Drop outs:

F: 73

[N]

OBE (youth): (3.67, 4.95)

OBE (youth): (2.13, nr)

baseline measures to intervention: 15, 50%

E: nr

OBE (caregiver): (4.47, 6.02)

OBE (caregiver): (1.53, nr)

at 3 months: 4, 27%

EO (youth): (48.80, 21.33,)

EO (youth): (45.87, nr)

Follow-up at 3 months:

EO (caregiver): (63.47, 22.70)

EO (caregiver): (55.33, nr)

Met criteria for BED: 1/11, 9%

OBE (youth): (1.36, nr)

OBE (caregiver): (1.09, nr)

EO (youth): (39.27, nr)

EO (caregiver): (41.09, nr)