Adapting an online guided self-help intervention for the management of binge eating in adults with type 2 diabetes: The POSE-D study.

People with type 2 diabetes are more likely to experience binge eating than the general population, which may interfere with their diabetes management. Guided Self-Help is the recommended treatment for binge eating disorder, but there is currently a lack of evidenced treatment for binge eating in individuals living with type 2 diabetes. Therefore, the aims of the current study were to adapt an existing evidence-based Guided Self-Help intervention using the principles of co-design to make it available online, suitable for remote delivery to address binge eating specifically in adults living with type 2 diabetes. The Working to Overcome Eating Difficulties GSH intervention comprises online GSH materials presented in 7 sections delivered over 12-weeks, supported by a trained Guide. In order to adapt the intervention, we held four collaboration workshops with three expert patients recruited from diabetes support groups, eight healthcare professionals and an expert consensus group. We used thematic analysis to make sense of the data. The main themes included; keeping the GSH material generic, adapting Sam the central character, tailoring the dietary advice and eating diary. The length of Guidance sessions was increased to 60 minutes, and Guide training was focussed around working with people with diabetes.