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Enhanced Cue Exposure Therapy for Negative Emotional Eating

Not Applicable
Recruiting
Conditions
Disordered Eating Behaviors
Binge Eating
Interventions
Behavioral: Enhanced Cue Exposure Therapy
Behavioral: Behavioral Lifestyle Intervention
Registration Number
NCT06012045
Lead Sponsor
The University of Hong Kong
Brief Summary

The current study aims to evaluate the efficacy of Enhanced Cue Exposure Therapy (E-CET) in reducing negative emotional eating (NEE), compared to an active control intervention, behavioral lifestyle intervention (BLI), in a parallel-group, participant-blinded, randomized controlled trial. The secondary aim is to evaluate whether changes in conditioned stimulus-unconditioned stimulus (CS-US) expectancies mediate the changes in NEE.

Detailed Description

Participants will be randomly assigned to either the experimental treatment or control BLI group. Participants in the experimental group will receive 6 weeks of E-CET treatment and those in the control group will receive 6 weeks of behavioral counselling integrating behavioral strategies for making changes related to diet and exercise. Outcomes will be assessed at baseline, posttreatment, and 3- and 12-month follow-ups.

Research question 1:

Is E-CET an efficacious intervention for reducing NEE?

Hypothesis 1:

E-CET will lead to greater reductions in NEE at posttreatment and follow-up compared to BLI.

Research question 2:

Does E-CET work via the violation of the CS-US expectancies?

Hypothesis 2:

Changes in the believability of CS-US expectancies will mediate the treatment effects of E-CET on NEE.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
138
Inclusion Criteria
  • aged 18 or over
  • a score >3.25 on the emotional eating subscale of the Dutch Eating Behavioural Questionnaire lasting for three months or longer
  • confirmed to have, on average, two or more NEE episodes per week using ecological momentary assessments (EMAs)
Exclusion Criteria
  • active suicidal intent or plan
  • psychiatric illnesses except mood disorders, anxiety disorders, and eating disorders because mood and anxiety disorders and symptoms are common in those with NEE
  • currently receiving psychotherapy, or adjusting to changing psychiatric medication
  • substance abuse
  • any conditions or circumstances that prevent the participant from receiving all treatment sessions

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Enhanced Cue Exposure TherapyEnhanced Cue Exposure TherapyThis is the experimental arm. Participants will receive the 6-session enhanced cue exposure therapy.
Behavioral Lifestyle InterventionBehavioral Lifestyle InterventionThis is the active control arm. Participants will receive the 6-session behavioral lifestyle intervention.
Primary Outcome Measures
NameTimeMethod
Number of EMA-measured NEE episodes14 months (up to 12-month follow-up)

Participants will respond to fixed-interval prompts asking whether they have engaged in NEE in the assessment period. The sum of all the reported episodes during the seven days will be computed to indicate the frequency of NEE per week.

Changes in the score on the emotional eating subscale of the Dutch Eating Behaviour Questionnaire (DEBQ)14 months (up to 12-month follow-up)

The subscale consists of 13 items assessing the tendency to eat in response to negative emotions, on a 5-point Likert scale from 1 (never) to 5 (very often). The cutoff point of \>3.25 is used to indicate negative emotional eating tendencies. Higher scores indicate greater tendency and severity.

Secondary Outcome Measures
NameTimeMethod
Changes in quality of life measured using the Satisfaction with Life Scale (SWLS)14 months (up to 12-month follow-up)

It is a 5-item scale measuring subjective life satisfaction on a 7-point scale ranging from 1 (strongly disagree) to 7 (strongly agree). Higher total scores indicate greater life satisfaction.

Changes in NEE14 months (up to 12-month follow-up)

It will be indexed by the association between negative emotionality and caloric consumption measured in three days a week. Negative emotionality will be measured using the four fixed interval prompts per day. Participants will be asked to select the negative emotions applied to them at the moment and rate the intensity of the selected negative emotions on a visual analog scale from 0 (not at all) to 100 (very intense). Caloric consumption will be measured by the 24-hour dietary recall interview conducted for three days a week. Stronger associations will indicate greater NEE.

Changes in caloric consumption14 months (up to 12-month follow-up)

It will be measured by the 24-hour dietary recall interview conducted for three days a week. Nutrition information on food intake (calories, protein, carbohydrates, fat, dietary fibre, sugar, and sodium) will be processed by trained research assistants.

Changes in external eating measured by the external eating subscale of the Dutch Eating Behaviour Questionnaire (DEBQ)14 months (up to 12-month follow-up)

The subscale consists of 10 items assessing the tendency to eat in response to external cues on a 5-point Likert scale from 1 (never) to 5 (very often). Higher scores indicate greater frequencies of disordered eating.

Changes in mood measured using the Depression, Anxiety and Stress Scale-21 (DASS-21)14 months (up to 12-month follow-up)

The scale consists of 21 items rated on 0 (not at all) to 3 (very much) Likert scales assessing symptoms of anxiety, depression, and stress.

Changes in eating disorder symptoms measured by the Eating Disorder Examination Questionnaire-Short (EDE-QS)14 months (up to 12-month follow-up)

It consists of 12 items assessing the symptoms of eating disorders for the preceding seven days rated on a 4-point Likert scale from 0 (0 days) to 3 (6-7 days). Higher global scores indicate greater eating disorder symptoms.

Changes in body weight14 months (up to 12-month follow-up)

It will be measured in the laboratory using a digital weighing scale.

Trial Locations

Locations (1)

The University of Hong Kong

🇭🇰

Hong Kong, Hong Kong

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