Introduction: Individual change in eating disorder (ED) symptoms after behavioral weight management interventions may vary. This study aimed to understand individual variability in change in eating disorder risk scores and binge eating following behavioural weight management interventions.
Methods: The EDIT Collaboration dataset was used for analysis. EDIT includes combined and harmonised data from randomised-controlled trials of behavioural weight management interventions conducted in adolescents (aged 10 to <19 years) or adults (aged ≥19 years) with overweight or obesity that assessed eating disorder risk. Using Eating Disorder Examination Questionnaire (EDE-Q) or Binge Eating Scale (BES), we describe proportions of participants moving across cut-points between baseline and latest timepoint. Reliable Change Index was used to analyse estimated change beyond measurement error.
Results: Six adolescent (n=555, 14y, 58%F) and 15 adult (n=1,457, 46y, 78%F) trials used EDE-Q. Most remained within the same risk category (77% below cut-point; 6·6% above), 12·0% moved from above to below the cut-point, and 5·1% moved from below to above. Reliable decreases were observed for 11·4% and increases for 2·7% of participants.
Four adolescent (n=406, 14·8[1·3] years, 60% female) and 10 adult (n=1,204, 43.4[12·3] years, 85% female) trials used the BES. Most remained within the same category (64·0% below; 13·0% above), 19·0% moved below the cut-point, and 3·8% moved above. Reliable decreases were observed for 10.3% and increases for 0·9%.
Conclusion: Most participants remained below risk thresholds, but one in five presented above a cut-point requiring further assessment. Some participants had a reliable reduction or increase in scores. Early identification of those with increasing eating disorder symptoms may prevent development of a full-syndrome eating disorder.