Video-based Guided Self Help Dialectical Behavior Therapy for Binge Eating Disorder (VIDEO-DBT-GSH)

Dialectical Behavior Therapy (DBT) is an effective treatment for eating disorders, showing promising remission rates for Binge Eating Disorder (BED) in both standard and guided self-help formats. Traditional guided self-help models typically combine weekly chapter readings with a limited number of brief therapist meetings. However, the requirement of weekly book readings can be particularly challenging for individuals with BED, who often exhibit impulsive personality traits, psychiatric comorbidities, and weight-related health problems.

This study was developed to test a version of guided self-help DBT-BED delivered through video lessons instead of text. This randomized clinical trial will be conducted at the Eating Disorders Program of the Institute of Psychiatry, Hospital das Clínicas, Faculty of Medicine, University of São Paulo (AMBULIM IPq HC FMUSP), Brazil. Eighty adults with BED will be randomized to either an experimental group (weekly video lessons) or a control group (weekly text-based readings).

Both groups will undergo a 13-week intervention, including six brief 30-minute online guidance sessions with a psychologist. The primary outcome will be full remission from binge eating episodes at the end of treatment and at the 3-month follow-up. Secondary outcomes will include changes in eating disorder psychopathology, emotion regulation, quality of life, self-esteem, and dropout rates. Statistical analyses will follow the intention-to-treat principle.

Study Overview

• Status: Active, not recruiting
• Conditions: Binge Eating Disorder
• Intervention / Treatment: Behavioral: Experimental: Video-based DBTgsh for BED; Behavioral: Traditional DBTgsh for BED (text-based model)

Detailed Description

The aim of this randomized controlled trial is to compare the efficacy of a video-based adaptation of guided self-help Dialectical Behavior Therapy for adults with Binge Eating Disorder (BED) with the traditional text-based guided self-help format. The study focuses on clinical remission of binge eating episodes, treatment adherence, and maintenance of therapeutic effects over time.

Eighty adults diagnosed with BED will be recruited through the Eating Disorders Program of the Institute of Psychiatry at the Hospital das Clínicas, Faculty of Medicine, University of São Paulo (AMBULIM IPq HC FMUSP), Brazil. Participants will be randomly assigned to one of two intervention groups. The experimental group will receive the content of the guided self-help DBT-BED manual delivered through weekly video lessons based on the book chapters. The control group will receive the same content in a traditional text-based guided self-help format, following the same weekly structure.

Both groups will participate in six brief individual online guidance sessions with a psychologist, each lasting approximately 30 minutes. These sessions are intended to support treatment engagement, clarify intervention content, address treatment-interfering behaviors, promote generalization of DBT skills, and enhance motivation throughout the intervention.

Assessments will be conducted at baseline, at the end of the intervention period, and at a 3-month follow-up. The primary outcome of the study will be complete remission of binge eating episodes at post-treatment and follow-up. Secondary outcomes will include changes in eating disorder psychopathology, emotional regulation, quality of life, self-esteem, and treatment dropout rates.

The study is scheduled to begin in February 2026, with anticipated completion in December 2026.

• Study Type: Interventional
• Enrollment (Estimated): 82
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Brazil
  • São Paulo
    • São Paulo, São Paulo, Brazil, 05403-903
      • AMBULIM IPq HC FMUSP

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Individuals diagnosed with binge eating disorder according to the DSM-5-TR.
• Access to a device with a camera, microphone, and internet connection.
• Minimum ability to read and write in Portuguese.
• Availability of 1 hour per week to read or watch treatment-related content.
• Participants with psychiatric comorbidities must be on a stable medication regimen for at least two months prior to enrollment in the study.

Exclusion Criteria:

• Individuals with anorexia nervosa or bulimia nervosa.
• Individuals with unstable psychiatric comorbidities (exclusion will apply to individuals who have experienced an acute psychiatric exacerbation requiring additional treatment or medical hospitalization.).
• Lack of time to read weekly chapters or watch the video lessons.
• Inability to access devices with a camera, microphone, and internet.
• Inability to attend six brief 30-minute videoconference sessions over the 13-week study period.
• Individuals at imminent risk to life (suicidal or self-harming behavior in the previous three months).
• Lack of minimum reading and writing skills.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Video-based DBTgsh for BED; Participants assigned to the experimental group will receive a 13-week guided self-help intervention based on Dialectical Behavior Therapy for Binge Eating Disorder (DBT-BED), delivered through weekly video lessons. The content is structured into three progressive modules covering core DBT skills: (1) mindfulness, (2) emotion regulation, and (3) distress tolerance. The video lessons will be adapted from the Portuguese version of The DBT Solution for Emotional Eating (Safer, Adler & Masson, 2020). In addition to the video content, participants will have access to six brief online sessions with a psychologist (30 minutes each), conducted via videoconference. These sessions will be distributed as follows: two in the first two weeks, three biweekly, and one at the end of the treatment.	Behavioral: Experimental: Video-based DBTgsh for BED; This is a guided self-help behavioral intervention based on Dialectical Behavior Therapy for Binge Eating Disorder (DBT-BED), delivered through weekly pre-recorded video lessons over 13 weeks. The intervention covers three core DBT skill modules-mindfulness, emotion regulation, and distress tolerance-and is supported by six brief 30-minute individual online guidance sessions with a psychologist to enhance adherence, clarify content, and support skill application.
Active Comparator: Traditional DBTgsh for BED (text-based model); Participants in the control group will receive the traditional guided self-help version of DBT-BED, using the guided self-help manual of The DBT Solution for Emotional Eating in the Portuguese version (Safer, Adler & Masson, 2020). Participants will be instructed to read one chapter per week over the 13-week treatment period. The content covers the same three core DBT modules: mindfulness skills, emotion regulation, and distress tolerance. As in the experimental group, participants will also participate in six online sessions with a psychologist (30 minutes each), following the same time schedule. These sessions will have the same objectives as those in the experimental group.	Behavioral: Traditional DBTgsh for BED (text-based model); This is a guided self-help behavioral intervention based on Dialectical Behavior Therapy for Binge Eating Disorder (DBT-BED), delivered through weekly chapter readings from a structured manual over 13 weeks. The intervention covers the same three core DBT skill modules-mindfulness, emotion regulation, and distress tolerance-and is supported by six brief 30-minute individual online guidance sessions with a psychologist to enhance adherence, clarify content, and support skill application.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Eating Disorder Examination Questionnaire (EDE-Q)	Eating Disorder Examination Questionnaire (EDE-Q) is a self-report measure assessing the severity of eating disorder psychopathology, including binge eating-related symptoms. The global score is calculated as the mean of four subscales. Scores range from 0 to 6, with higher scores indicating greater eating disorder psychopathology.	Pre-treatment (baseline), post-treatment at 13 weeks, and 3-month follow-up.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Difficulties in Emotion Regulation Scale (DERS)	Difficulties in Emotion Regulation Scale (DERS) is a self-report measure assessing difficulties across multiple aspects of emotional regulation, including emotional awareness, acceptance of emotional responses, impulse control, and access to effective emotion regulation strategies. The total score is calculated as the sum of 36 items. Scores range from 36 to 180, with higher scores indicating greater difficulties in emotion regulation.	Pre-treatment (baseline), post-treatment at 13 weeks, and 3-month follow-up.
Short Form Health Survey (SF-36)	Short Form Health Survey (SF-36) is a generic self-report questionnaire assessing health-related quality of life across multiple domains, including physical functioning, role limitations due to physical or emotional problems, bodily pain, vitality, social functioning, emotional well-being, and general health perception. Scores range from 0 to 100, with higher scores indicating better perceived health status and fewer functional limitations.	Pre-treatment (baseline), post-treatment at 13 weeks, and 3-month follow-up.
Rosenberg Self-Esteem Scale (RSES)	Rosenberg Self-Esteem Scale (RSES) is a self-report instrument designed to assess global self-esteem, reflecting overall feelings of self-worth and self-acceptance. The scale consists of 10 items rated on a Likert-type format, with the total score calculated as the sum of all items. Scores range from 0 to 30, with higher scores indicating higher levels of self-esteem.	Pre-treatment (baseline), post-treatment at 13 weeks, and 3-month follow-up.

Collaborators and Investigators

• Sponsor: University of Sao Paulo General Hospital
• Investigators: Study Director: Táki Cordas, Medical Coordinator, Eating Disorders Program of the Psychiatry Institute, Hospital das Clínicas, Medical School, University of São Paulo (AMBULIM IPq HC FMUSP), Brazil.

Publications and helpful links

General Publications

• Ben-Porath, D., Duthu, F., Luo, T., Gonidakis, F., Compte, E. J., & Wisniewski, L. (2020). Dialectical behavioral therapy: an update and review of the existing treatment models adapted for adults with eating disorders. Dialectical Behavior Therapy for Eating Disorders, 5-25. DOI: 10.1080/10640266.2020.1723371. Carter, J. C., Kenny, T. E., Singleton, C., Van Wijk, M., & Heath, O. (2020). Dialectical behavior therapy self-help for binge-eating disorder: A randomized controlled study. International Journal of Eating Disorders, 53(3), 451-460.Masson, P. C., von Ranson, K. M., Wallace, L. M., & Safer, D. L. (2013). A randomized wait-list controlled pilot study of dialectical behaviour therapy guided self-help for binge eating disorder. Behaviour research and therapy, 51(11), 723-728.Safer, D. L., Adler, S., & Masson, P. C. (2018). The DBT solution for emotional eating: A proven program to break the cycle of bingeing and out-of-control eating. Guilford Publications.

Study record dates

Study Major Dates

• Study Start (Actual): February 2, 2026
• Primary Completion (Estimated): October 23, 2026
• Study Completion (Estimated): December 20, 2026

Study Registration Dates

• First Submitted: December 25, 2025
• First Submitted That Met QC Criteria: December 25, 2025
• First Posted (Actual): January 8, 2026

Study Record Updates

• Last Update Posted (Actual): June 3, 2026
• Last Update Submitted That Met QC Criteria: June 2, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Dialectical Behavior Therapy; DBT; Guided Self-Help; BED; Video-based intervention; DBT-BED; DBTgsh
• Additional Relevant MeSH Terms: Mental Disorders; Feeding and Eating Disorders; Binge-Eating Disorder; Equipment and Supplies; Equipment and Supplies, Hospital; Beds
• Other Study ID Numbers: 88641125.1.0000.006

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: At the time of registration, a decision regarding the sharing of individual participant data (IPD) has not yet been made. The research team will evaluate the feasibility of IPD sharing after study completion, considering ethical approvals, participant consent, data protection regulations, and institutional policies. Any future data sharing will be limited to de-identified data and will follow applicable legal and ethical requirements.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No