Introduction: Binge eating (BE) is considered the most common eating disorder. It is strongly associated with obesity and presents a barrier to effective weight management (WM). Guided Self Help (GSH) interventions are recommended for BE, but most people have never received any support for this problem. This thesis presents a qualitative study examining guides’ and clients’ experiences of change using a GSH intervention called ‘Working to Overcome Eating Difficulties’ (WOED) for adults with BE and obesity, prior to engaging in WM.
Method: After receiving or facilitating WOED, nine clients and four guides were interviewed remotely using an adapted version of the client change interview (CCI). Results were analysed using reflexive thematic analysis.
Results: Analysis indicated that WOED offered something ‘new’ for both parties and was positively received. Clients were unlikely to have had the space to talk about BE before and guides were not used to offering one-to-one support. The relationship with the guide, intervention itself and client factors (e.g. engagement and access to positive social support) facilitated positive outcomes. Some areas of the manual and other client factors (mental/physical health problems, lack of social support, concrete focus on weight loss) presented barriers to engagement/change.
Discussion: Offering GSH targeting BE was well received prior to WM, but it may not be appropriate for all. Training for guides needs to reflect this and accommodate guides’ levels of experience, to enable wider dissemination of the programme. Further research is required to determine whether the addition of GSH prior to WM for BE participants increases the effectiveness and acceptability of subsequent WM interventions. Other clinical and research recommendations are made and strengths and limitations explored.
