IMPULS: Impulsivity-Focused Group Intervention to Reduce Binge Eating Episodes in Patients with Binge Eating Disorder – A Randomised Controlled Trial

Abstract

Background: Impulsivity is a risk factor for binge eating disorder, and binge eating (BE) equates to impulsive eating behaviour. Hence, we developed IMPULS, a cognitive behavioural group intervention focusing on impulsive eating. Methods: We randomised 41 patients to the IMPULS group and 39 to the control group. The IMPULS group participated in the IMPULS treatment, while both groups completed weekly self-observations. We compared both groups concerning BE episodes in the past 4 weeks at the end of treatment (primary outcome). As secondary outcomes, we investigated eating pathology, depression, general impulsivity and body mass index (BMI) at the end of treatment and in a 3-month follow-up. Results: The primary outcome failed, because BE episodes in the past 4 weeks were reduced in both groups at the end of treatment. At follow-up, the IMPULS group showed further improvement, contrary to the control group. The BE days/episodes in the 2 months before were overall reduced in both groups. Eating pathology was reduced in the IMPULS group at the end of treatment and partly in both groups at the follow-up. Depression was only reduced in the IMPULS group. General impulsivity and BMI did not change. Conclusions: The IMPULS study has a negative primary outcome. However, secondary outcomes indicate that the IMPULS treatment might be promising, as BE, eating pathology and depression were reduced in the IMPULS group. The initially reduced BE in the control group might represent a short-term effect from the self-observations. General impulsivity and BMI might need a longer time or more intensive treatment to change.

Eating behaviour and symptom trajectories in patients with a history of binge eating disorder during COVID‐19 pandemic

“…Regarding clinical ED diagnoses, there is a lack of research in people suffering from the most prevalent ED which is binge eating disorder (BED). The goal of the present study was to investigate ED symptoms as well as general psychopathology directly after the first COVID‐19 lockdown in spring 2020 in patients with a history of BED who were previously seeking treatment in the randomised‐controlled IMPULS trial (Schag et al., 2019). We used a combination of expert‐rated structured clinical interview diagnosis as well as self‐report data and additionally explored potential influencing factors on ED symptom trajectories.…”

The treatment of binge eating disorder with cognitive behavior therapy and other therapies: An overview and clinical considerations

“…Additionally, assessments of treatment completers showed significant reductions in binge eating only in those submitted to ImpulsE 82 . In line with this, the efficacy of addressing impulsivity to reduce binge eating was shown in another randomized controlled trial that tested a group intervention focused on impulsivity, namely, IMPULS 83 . In this trial, 80 participants with BED were randomized to 8 weekly sessions of IMPULS, or to a control condition which consisted of online self‐observations 83 .…”

“…In that study, participants submitted to IMPULS reduced binge eating by the end of treatment and maintained this reduction at the 3‐month follow‐up assessment after treatment completion 83 . In contrast, participants in the control condition reduced binge eating by the end of treatment, but relapsed to baseline levels at 3‐month follow‐up 83 . The aforementioned studies showed that impulsivity‐focused therapies can be effective to reduce binge eating in people with BED.…”

“…In this trial, 80 participants with BED were randomized to 8 weekly sessions of IMPULS, or to a control condition which consisted of online self‐observations 83 . In that study, participants submitted to IMPULS reduced binge eating by the end of treatment and maintained this reduction at the 3‐month follow‐up assessment after treatment completion 83 . In contrast, participants in the control condition reduced binge eating by the end of treatment, but relapsed to baseline levels at 3‐month follow‐up 83 .…”

Measuring Success in Psychotherapy Trials: The Challenge of Choosing the Adequate Control Condition

“…Particularly in the case of those mental disorders for which a structured monitoring of symptoms is an integral part of therapy, an intensive process and multistep outcome monitoring can also have a certain therapeutic effect. Such aspects of selfmonitoring should be discussed at least in the case of significant control group effects [11].…”