Table 3 Modular cognitive-behavioral group therapy for binge eating disorder ^a

Initial treatment phase (sessions 1 to 3)

· Motivational enhancement

· Psychoeducation

· Self-monitoring of food intake

· Development of an individual maintenance model

· Goal-setting

· Cognitive interventions for motivation

Intensive treatment phase (sessions 4 to 17)

· Normalizing eating behavior

Eating Behavior Module

· Identification and modification of dysfunctional thoughts and schemata

· Nutritional management

· Acquisition of new skills

· Hunger and satiety perception training

· Establishment of regular physical activity

· Cue exposure

· Hedonics exercise

· Cognitive interventions for negative schemata related to eating behavior

Body Image Module

· Body image diary

· Body image exposure

· Exposure to avoided body-related situations

· Body hedonics exercise

· Shaping of regular physical activity

· Cognitive interventions for negative body-related schemata

Stress Module

· Stimulus and response control

· Stress management techniques

· Affect regulation techniques

· Interpersonal problem-solving

· Social competence training

· Cognitive interventions for further relevant negative schemata

· Exposure in case of further significant anxiety and avoidance

· Homework and practice

General techniques used in all modules

· Psychoeducation

· Self-monitoring

· Goal-setting

· Self-reinforcement

Self-management phase (sessions 18 to 20)

· Patients become their own therapists

· Development of realistic expectations concerning potential setbacks of binge eating

· Maintaining progress in the future

· Development of relapse prevention strategies

· Relapse prevention