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Food Addiction Symptoms and Clinical Outcomes in Binge-Type Eating Disorders: A Randomized Clinical Trial of Cognitive Behavioral Therapy-Guided Self-Help in China

Chen S, Gao X, Gu L, Wei Y, Gao R, Han H, Chen Y, Jiang A et al.

The International journal of eating disorders, 2026

87 participants · 1 citation

Abstract

Objective: Food addiction (FA) is clinically relevant in binge-type eating disorders (EDs), yet its treatment relevance remains unclear in mainland China. This study examined (1) FA's associations with ED psychopathology and psychosocial functioning; (2) FA symptom changes following cognitive behavioral therapy-guided self-help (CBT-gsh); and (3) whether FA improvement was independently associated with changes in psychosocial functioning.

Method: In this assessor-blind randomized controlled trial, 87 adults with binge-type EDs were allocated to a 10-week asynchronous web-based CBT-gsh program or a waitlist control group. Assessments occurred at baseline, post-treatment, and 1-month follow-up. FA severity was the primary outcome; secondary outcomes included ED psychopathology, binge-eating frequency, psychosocial impairment, depression/anxiety, and body mass index (BMI). Linear mixed models and hierarchical regression were used to analyze the data.

Results: At baseline, FA severity was positively associated with ED psychopathology and psychosocial impairment. All outcomes except BMI improved significantly in the intervention group (all ps < 0.001), with no changes in controls. At post-treatment, 20% of intervention participants achieved binge-eating abstinence versus 2.5% of controls, and fewer met moderate-to-severe FA criteria (Δn = -16) in the intervention group. FA reduction was independently associated with lower post-treatment psychosocial impairment (β = 0.49, p <…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 87 participants or records.

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