Obesity Abstracts

Background: Subclinical binge eating (SCBE) is highly prevalent in patients with obesity1. Active Binge Eating Disorder (BED) typically requires specialist psychiatric intervention but SCBE patients may be inappropriately excluded from weight management services whilst lacking a formal BED diagnosis. Evidence suggests dysglycaemia and binge eating exist in a mutually reinforcing cycle2, yet differential treatment responses remain unexplored. This analysis evaluates 6 month (6m) changes in binge eating symptoms in patients with and without dysglycaemia receiving care and incretin mimetics in the digital arm (Roczen) of a digitally-integrated NHS complex obesity service in the East-of-England.

Methods: All patients underwent comprehensive BED assessment at onboarding by a SCOPE-certified clinician, including the Binge Eating Scale (BES) questionnaire. Where required, psychological support is delivered via multidisciplinary team meetings led by a bariatric clinical psychologist, group sessions, and ongoing clinical management. Paired baseline and 6m BES scores were available for 37 patients. To control for medication effects, two patients not receiving incretin mimetics were excluded, creating a medicated analysis cohort (n =35; tirzepatide n = 12, semaglutide n = 23). Participants were categorised by dysglycaemia status: non-dysglycaemia (n =25) or dysglycaemia (n =10, comprising prediabetes n = 9, and Type 2 diabetes n = 1). Given the modest sample sizes, analyses emphasised descriptive summaries.

Results: At 6m, the intervention significantly reduced binge eating scores overall (mean change: -6.77±9.64, n = 35, P <0.001). Mean baseline BES scores were lower in the non-dysglycaemia vs dysglycaemia group (13.2 and 16.8, respectively). Post-intervention, the dysglycaemia group showed a numerically greater mean BES reduction (-9.5 points, -56.5% reduction, n = 10) compared to the non-dysglycaemia group (-5.7 points, -43.2% reduction, n = 25).

Conclusion: On average, patients receiving multidisciplinary obesity care and incretin mimetics within an integrated digital NHS service showed significant reductions in binge eating symptoms. This demonstrates a care model that may avoid inappropriate exclusion of patients affected by SCBE. Descriptive findings suggest greater improvements in patients with co-morbid dysglycaemia, though small subgroup sizes preclude definitive conclusions. These preliminary results support the potential for integrated digital services utilising incretin mimetics to address interconnected metabolic and eating behaviour challenges in NHS settings.

Conflicts of interest: AB, DP, JK, SS, BM are on the medical advisory board and are shareholders in Reset Health. LF and TC are employed at Reset Health. CA is employed at Roczen Ltd.