Feasibility and clinical outcomes of tailored digital CBT-E guided self-help for youth with binge-eating symptoms: A pilot randomized controlled trial

Abstract

Binge eating in adolescents and young adults is a clinically significant concern due to its risk of progression to full-syndrome eating disorders and functional impairment. Digital guided self-help (GSH) based on enhanced cognitive behavioral therapy (CBT-E) is a scalable intervention, but implementing individualized approaches within digital platforms remains challenging. This pilot randomized controlled trial used a 2-arm waitlistcontrolled crossover design to evaluate the feasibility and preliminary efficacy of PlanEat, a developmentally and symptom-tailored digital CBT-E-based GSH program. Participants aged 13-22 years (N = 64) reporting binge-eating symptoms were randomized to intervention or waitlist control. Assessments were conducted at baseline, post-intervention, and 16-week follow-up, and analyzed using linear mixed-effects models. In intentionto-treat analyses, feasibility was supported by high usability and acceptable retention. At post-intervention, the intervention group showed significantly greater reductions in eating disorder symptoms than the waitlist group, with improvements in self-esteem and psychosocial functioning. These effects were maintained at follow-up. The waitlist group showed nonsignificant changes following crossover. This pilot study supports the feasibility and preliminary effectiveness of a developmentally and symptomatically tailored digital CBT-E intervention. A fully powered trial with extended follow-up is warranted. Trial Registration: ClinicalTrials.gov Identifier: NCT05615090