Abstract
Background: Binge eating disorder (BED) is the most common eating disorder. It is strongly associated with obesity and presents a barrier to effective weight management. This study examined clients' and Guides' experiences of a guided self-help (GSH) intervention for adults with binge eating and obesity, delivered prior to weight management. Methods: Participants were recruited through a behavioural weight management programme and were offered GSH prior to starting. Nine clients with binge eating and four Guides who supported clients were interviewed about their experiences of receiving or facilitating GSH, using an adapted version of the Client Change Interview (CCI)-a semi-structured schedule reflecting on helpful/unhelpful aspects and of the intervention and attributions of change. Interviews were transcribed and analysed using reflexive thematic analysis. Results: Themes were organized under 3 main headings. First, GSH offered something new for both parties and was positively received. Clients were unlikely to have had the space to talk about binge eating before and Guides were positive about offering one-to-one support. Second, participants spoke about a range of positive changes to binge eating and how clients felt about themselves and their social relationships. Third, there was agreement on the importance of clients' relationship with their Guide, the intervention materials, and a helpful mindset as factors facilitating change. Barriers were some aspects of the intervention and the complexity of clients' lives. Conclusions: Offering GSH targeting binge eating prior to weight management was well received. Some tailoring of the approach is recommended, specifically in terms of training for Guides to help in early client engagement. Further research should determine whether the opportunity of GSH for those with binge eating improves the acceptability and effectiveness of later-offered weight management, and the best sequencing of interventions.