Adapting Barlow's Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Overweight Adults: A Nonrandomized Controlled Feasibility Study.

Abstract

Objective: To evaluate the feasibility and potential effectiveness of the Unified Protocol for Emotional Eating (UP-EE) in a group format.

Method: Fifty-seven participants exhibiting high to severe emotional eating (EE) were assigned to an 8-week group intervention or to a control group receiving treatment as usual (TAU). EE (measured with the Dutch Eating Behavior Questionnaire) was the primary outcome, while state anxiety (State-Trait Anxiety Inventory [STAI-S]), depression (Beck Depression Inventory [BDI-II]) and perceived stress (Perceived Stress Scale [PSS-14]) were the secondary measures, assessed at baseline and post-intervention, or 8 weeks later in the control group. Satisfaction was measured via the Client Satisfaction Questionnaire (CSQ-8). Effectiveness was estimated using a linear mixed-effects model.

Results: The UP-EE received positive feedback and achieved an acceptable treatment retention. There were no significant differences regarding sociodemographic and clinical characteristics between groups. While both groups were not significantly different at the end of the intervention, the waitlist group worsened in anxiety, depression, and perceived stress, and showed only a slight improvement in EE. In contrast, the intervention group showed significant improvements across these variables, with a sharper decrease in EE. Results were consistent across both per-protocol and intention-to-treat analyses.

Conclusions: A group UP-EE intervention is a feasible intervention. Future research should focus on a larger sample with a randomized controlled trial design and utilize measures of disordered eating to more clearly identify the superiority of the intervention over a comparison condition.