A Randomized Controlled Trial of Motivational Interviewing for Binge Eating

Rationale: Motivational Interviewing (MI) is a collaborative therapy that focuses on strengthening a person’s internal motivation to change (Miller & Rollnick, 2002, 2012). Research suggests that MI may be helpful for treating binge eating; however, findings are limited and little is known about how MI for binge eating compares to active therapy controls. As such, the present study aimed to build on the current literature by comparing the efficacy of MI as a prelude to self-help treatment for binge eating to psychoeducation as a prelude to self-help treatment for binge eating. Method: Participants with full or subthreshold DSM-IV Binge Eating Disorder (BED) or nonpurging Bulimia Nervosa (BN-NP) were randomly assigned to receive either 60 minutes of MI followed by an unguided cognitive behavioural self-help manual (n = 24) or 60 minutes of psychoeducation followed by an unguided cognitive behavioural self-help manual (n = 21). Questionnaires were completed immediately before and after the treatment session, as well as at 1 month and 4 months post-session. Changes in readiness to change, confidence in ability to control binge eating, binge eating frequency and severity, eating disorder behaviours and attitudes, self-esteem, and depression were examined. Results: Findings revealed that MI significantly increased readiness to change and confidence in ability to control binge eating, whereas psychoeducation did not. Participants in the MI condition reported a significantly stronger therapeutic alliance than did participants in the psychoeducation condition. No group differences were found when changes in eating disorder and associated symptoms were examined; both groups showed significant overall improvements in eating disorder symptoms, binge eating frequency and severity, and self-esteem. Conclusions: MI offers benefits for increasing motivation, self-efficacy, and therapeutic alliance in treating individuals with clinically significant binge eating problems. However, it is not a uniquely effective treatment approach for reducing binge eating and other eating disorder symptoms.