Cognitive behavioral telehealth treatment for adolescents with loss-of-control eating: A randomized controlled feasibility study.

This study aimed to develop and test the feasibility and acceptability of a telehealth treatment for adolescent loss-of-control (LOC) eating, including the feasibility of attaining clinically meaningful outcomes. LOC-eating episodes occur when experiencing a sense of LOC while eating a subjectively or objectively large amount of food. Participants were 55 adolescents (aged 12-17) with recurrent LOC-eating episodes and elevated weight (based on age and sex-normed percentiles) who enrolled in a feasibility trial of cognitive behavioral therapy (CBT). Five participants enrolled in the treatment development "open series" and provided feedback. Fifty participants were randomized to the subsequent randomized controlled trial and received either CBT-LOC or nutrition education. Treatment fidelity was checked. CBT-LOC for adolescents with LOC eating demonstrated treatment feasibility and acceptability. Retention (M = 15.3 of 16 sessions), treatment credibility (M = 5.26 of 6), and treatment fidelity (92%-100% of broad topics covered) were high. Treatment satisfaction was higher in CBT-LOC than nutrition education (ps < .001). Time × Intervention effects revealed greater improvements for CBT-LOC than nutrition education for binge eating, LOC eating, secretive eating, and global eating-disorder psychopathology. Weight change was minimal for both interventions. Among adolescents with weekly or greater baseline LOC-eating episodes, overvaluation of weight/shape and depression also improved. Overall, this feasibility randomized controlled trial testing CBT-LOC for adolescents experiencing LOC eating and elevated weight demonstrated feasibility and acceptability. Initial evidence demonstrated that it was feasible to produce clinically significant improvements in LOC-eating episodes, eating behaviors, and eating-disorder psychopathology. Few participants attained decreased weight, which may limit motivation to seek treatment from parents and adolescents. (PsycInfo Database Record (c) 2026 APA, all rights reserved).