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Binge eating, whether formally diagnosed or occurring at subthreshold levels, is associated with adverse health consequences and decreased quality of life.
Access to accessible, cost-effective interventions that effectively address binge eating episodes is critical for individuals with this condition, and smartphone applications have demonstrated promise in treating binge eating and related disorders.
This study aims to evaluate the efficacy of eMOTE, a novel smartphone application for binge eating based on Dialectical Behavior Therapy (DBT) skills. For this purpose, a randomized controlled trial will be conducted in which women who self-report binge eating episodes will be randomly assigned to the app intervention group or a waiting list group.
eMOTE is a self-help application for women struggling with binge eating episodes. The application was developed based on DBT skills and has four modules: psychoeducation, mindfulness skills, emotion regulation skills, and distress tolerance skills. Additionally, it includes two self-monitoring diaries that allow the input of data related to food, behaviors, feelings, and exercises. The application content will be delivered through text, audios, and videos.
For this study, adult individuals with binge eating episodes who are fluent in Portuguese and own a smartphone will be recruited. The recruitment will be conducted through social media, the University of Porto, and other relevant institutions.
Participants who enrol in eMOTE will be required to fill out online self-report instruments and provide their body mass index (BMI) at baseline (T0), two months (T1), and four months after randomization (T2). A researcher not involved in the study will conduct the randomization process.
Participants will be randomly allocated to two groups: the experimental and control groups. In the experimental group, the participants will have access to eMOTE for eight weeks, while in the control group, the participants will be on a waiting list for eight weeks, and after this period, the participants will have access to eMOTE. The investigators will analyze the changes in the frequency of objective and subjective binge eating episodes, eating disorder psychopathology, BMI, intuitive eating, depression, anxiety, stress, compensatory behaviors, mindfulness, and difficulties in emotion regulation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| eMOTE | Experimental | Participants will have access to eMOTE for eight weeks. |
|
| Waiting List | No Intervention | Participants will be on a waiting list group for eight weeks. After that period, the participants will have access to eMOTE. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| eMOTE | Behavioral | The intervention combines psychoeducation, mindfulness skills, emotion regulation skills, and distress tolerance skills, along with self-monitoring of meals, behaviours and feelings. |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in binge eating symptoms | Assessed by Binge Eating Scale - BES. The Binge Eating Scale (BES) is a 16-item self-report questionnaire used to assess the presence and severity of binge eating behaviors. The scale's total score can range from 0 to 46, with higher scores indicating more severe levels of binge eating. | From Baseline to 2-months follow-up |
| Changes in objective binge eating episodes | Assessed by Eating Disorder Examination Questionnaire - EDE-Q. The Eating Disorder Examination Questionnaire (EDE-Q) is a 36-item self-report tool designed to assess the range, frequency, and severity of behaviors associated with eating disorder diagnoses. The total score on the EDE-Q can range from 0 to 6, with higher scores indicating more severe eating difficulties. | From Baseline to 2-months follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in BMI | Assessed by a Body Composition Analyzer | From Baseline to 2-months follow-up |
| Changes in intuitive eating | Assessed by Intuitive Eating Scale-2 - IES-2. The Intuitive Eating Scale-2 (IES-2) includes 23 items assessing various dimensions of intuitive eating. The total score on the IES-2 can range from 1 to 5, with higher scores indicate a greater tendency toward intuitive eating behaviors. |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in emotion regulation | Assessed by Difficulties in Emotion Regulation Scale - DERS. The Difficulties in Emotion Regulation Scale (DERS) is a 36-item self-report questionnaire designed to assess difficulties in emotional regulation. The total score on DERS can range from 36 to 180, with higher scores indicating greater difficulties in regulating emotions. | From Baseline to 2-months follow-up |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Telma Cruz, MSc | Contact | 220400667 | 393 | telmandreiacruz@gmail.com |
| Mariana Martins, PhD | Contact | 220400667 | 393 | mmartins@fpce.up.pt |
| Name | Affiliation | Role |
|---|---|---|
| Telma Cruz, MSc | Universidade do Porto | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Psychology and Educational and Education Sciences | Recruiting | Porto | Porto District | 4200-135 | Portugal |
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| ID | Term |
|---|---|
| D002032 | Bulimia |
| D001068 | Feeding and Eating Disorders |
| ID | Term |
|---|---|
| D006963 | Hyperphagia |
| D012817 | Signs and Symptoms, Digestive |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| From Baseline to 2-months follow-up |
| Changes in depression, anxiety and stress | Assessed by Depression, Anxiety and Stress Scale - 21 - DASS-21. The Depression Anxiety Stress Scales-21 (DASS-21) is a 21-item self-report questionnaire designed to measure levels of depression, anxiety, and stress. The scale provides three scores, one for each subscale, where the minimum is 0 and the maximum is 21, with higher scores indicate greater severity of emotional distress in each of these areas. | From Baseline to 2-months follow-up |
| Changes in eating disorder psychopathology | Assessed by Eating Disorder Examination Questionnaire - EDE-Q. The Eating Disorder Examination Questionnaire (EDE-Q) is a 36-item self-report tool designed to assess the range, frequency, and severity of behaviors associated with eating disorder diagnoses. The total score on the EDE-Q can range from 0 to 6, with higher scores indicating more severe eating difficulties. | From Baseline to 2-months follow-up |
| Changes in subjective binge eating episodes | Assessed by Eating Disorder Examination Questionnaire - EDE-Q. The Eating Disorder Examination Questionnaire (EDE-Q) is a 36-item self-report tool designed to assess the range, frequency, and severity of behaviors associated with eating disorder diagnoses. The total score on the EDE-Q can range from 0 to 6, with higher scores indicating more severe eating difficulties. | From Baseline to 2-months follow-up |
| Changes in compensatory behaviors | Assessed by Eating Disorder Examination Questionnaire - EDE-Q. The Eating Disorder Examination Questionnaire (EDE-Q) is a 36-item self-report tool designed to assess the range, frequency, and severity of behaviors associated with eating disorder diagnoses. The total score on the EDE-Q can range from 0 to 6, with higher scores indicating more severe eating difficulties. | From Baseline to 2-months follow-up |
| Acceptability | Assessed by utility and satisfaction with the digital intervention. Participants will rate the usefulness of each module and their satisfaction with it, using a scale from 1 to 5, ranging from "not at all" to "extremely". | T1 - immediately after intervention |
| Changes in mindfulness | Assessed by Mindful Attention and Awareness Scale - MAAS. The Mindful Attention and Awareness Scale (MAAS) is a 15-item self-report instrument that measures the extent to which individuals act with awareness in daily life. The total score can range from 1 to 6, and higher scores indicate more mindfulness. | From Baseline to 2-months follow-up |
| D001523 | Mental Disorders |