Binge Eating Disorder: Recognition and Guided Self-Help Treatment in an Underserved Population

Abstract

Data presented in this paper address questions about binge eating disorder (BED) recognition as a barrier to care, attitudes toward binge eating treatment options, and feasibility of guided self-help (GSH) cognitive behavioral therapy (CBT) for binge eating in black American, lower socioeconomic status (SES) women. This paper presents results from two studies. In Study 1, equal numbers of black and white American women completed a computerized experiment in which they were presented with photographic and narrative vignettes of women with BED who were either black or white American and of lower or higher SES. Study 2 participants completed this recognition task, after which half were randomized to GSH CBT based on Overcoming Binge Eating (Fairburn, 2013) and encouraged to use the Recovery Record mobile application ("Recovery Record," 2014) for self-monitoring. Additionally, Study 2 participants rated the acceptability of evidence-based binge eating treatments and modes of delivery. Findings emphasize that overall BED recognition is low, with some evidence that white, lower SES women are more likely to recognize BED and that community recognition is lower when symptoms present in black, lower SES women. Pilot study results also indicate that recruiting participants appears to be the biggest barrier to GSH CBT in black, lower SES women, although the average initiation rate, low attrition rate, and general acceptability rankings of GSH CBT found here support the potential utility of this treatment.