Interventions for improving psychological symptoms in binge eating disorder (BED) and loss of control (LOC) eating in childhood and adolescence: a systematic scoping review

Abstract

Abstract Background Despite reports of high incidence and prevalence, relatively few studies have investigated outcomes for children and adolescents with binge eating disorder (BED) and loss of control (LOC) eating. This study aimed to scope the available literature systematically. Methods A systematic scoping review methodology was implemented. Five databases (Medline, PsycInfo, Embase, CENTRAL and Scopus) were searched on the 23rd of August 2024 for relevant peer-reviewed journal articles and dissertations. No beginning time point was specified, and the end time point was chosen as the 23rd of August 2024. Restrictions were placed on age (under 20), diagnosis (BED, LOC eating) and study design (quantitative). Results Ten quantitative studies were identified: eight randomised controlled trials and two case series. Outcome data for 2400 young people were synthesised. Most studies (70%) had a sample size of fewer than 100 participants. Treatment modalities were heterogeneous and included psychological therapies such as cognitive behavioural therapy (CBT), dialectical behavioural therapy (DBT), interpersonal therapy (IPT) and group schema therapy. One study examined the role of medication. The results suggested that six different treatment modalities (CBT (group and individual), IPT, DBT, family-based IPT (FB-IPT), and medication) were associated with a reduction in the number of binge eating episodes and LOC eating. In terms of other psychological aspects such as depression, anxiety and self-esteem, the data were sparse, and it was difficult to draw meaningful conclusions. Conclusions The findings highlight a paucity of evidence-based interventions in this area for young people with BED and LOC eating. This is an emerging and important field in child and adolescent eating disorders as it is now ten years since BED was introduced into the DSM-V with prevalence estimates higher than other eating disorders in this population. As the onset of binge eating often occurs in late childhood or adolescence there is a role for early intervention. Further research into the efficacy of different therapeutic options for this age group is needed. Plain English Summary In this review, the authors searched for studies where treatment for binge eating disorder (BED) or loss of control eating (LOC) in young people (under 20 years old) had been trialled. They wanted to see which treatments could improve the mental health of young people with these conditions. To ensure that as many studies as possible were included, five different databases were searched. Ten studies were found and the majority of these were small studies with less than 100 participants. Nine of the studies investigated the role of talking therapies, for example, cognitive behavioural therapy and one study examined how medication helped. The talking therapies used in each of the nine studies were varied. The authors found that, on the whole, talking therapy and medication helped with the number of binge eating episodes and LOC eating but it was less easy to understand if they helped with depression and anxiety which are both commonly associated with BED and LOC eating. The results of this review show that more research is needed into this area as few studies were found and BED and LOC eating are becoming more frequently diagnosed in young people.

Keywords

• Binge eating disorder
• Loss of control eating
• Adolescence
• Childhood
• Interventions
• CBT