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Nutrients
Volume 17
Issue 12
10.3390/nu17122003
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Article

Group Dialectical Behavior Therapy for Binge Eating Disorder: Emotion Dysregulation and Alexithymia as Mediators of Symptom Improvement

by
Luca Zompa
1,†,
Emanuele Cassioli
1,†,
Eleonora Rossi
1,
Valentina Zofia Cordasco
1,
Leda Caiati
1,
Stefano Lucarelli
2,
Ilenia Giunti
2,
Lisa Lazzeretti
2,
Giulio D’Anna
2,
Simona Dei
3,
Giuseppe Cardamone
4,
Valdo Ricca
1,
Francesco Rotella
1,* and
Giovanni Castellini
1
1
Psychiatry Unit, Department of Health Science, University of Florence, 50100 Florence, Italy
2
Eating Disorders Unit, Central Tuscany Local Health Authority, 50142 Florence, Italy
3
Central Tuscany Local Health Authority, 50142 Florence, Italy
4
Department of Mental Health, AUSL Toscana Centro, 59100 Prato, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Nutrients 2025, 17(12), 2003; https://doi.org/10.3390/nu17122003 (registering DOI)
Submission received: 14 May 2025 / Revised: 11 June 2025 / Accepted: 13 June 2025 / Published: 14 June 2025
(This article belongs to the Section Nutrition Methodology & Assessment)
Versions Notes

Abstract

Background/Objectives: Dialectical Behaviour Therapy (DBT) has emerged as a promising intervention for Eating Disorders (Eds), especially Binge Eating Disorder (BED), which is often characterized by severe emotion dysregulation. The aims of this study were to evaluate the longitudinal course of BED symptomatology following a group-based DBT intervention focused on two specific modules, Emotion Regulation and Distress Tolerance, and to examine the mediating role of emotion dysregulation and alexithymia in symptom improvement. Methods: This non-randomized longitudinal clinical study involved 170 patients with BED who received a 16-week DBT group treatment including modules targeting emotion regulation and distress tolerance. Self-report questionnaires were administered at baseline (T0) and at the end of treatment (T1). Linear mixed models were used to analyze the longitudinal trend, and a mediation analysis was conducted to examine whether changes in emotion dysregulation and alexithymia mediated symptom improvement. Results: Longitudinal analyses showed a significant reduction in BED symptoms at the end of treatment as well as in the levels of emotion dysregulation and alexithymia. Mediation analyses revealed that both emotion dysregulation (indirect effect: −0.68 [−1.20; −0.31]) and alexithymia (indirect effect: −0.59 [−1.33; −0.20]) significantly mediated the improvement in BED symptoms over time. Conclusions: These findings support the application of focused DBT group interventions targeting emotion regulation and distress tolerance in reducing BED symptomatology. Emotion dysregulation and alexithymia were identified as mediators of longitudinal clinical improvement, highlighting the importance of modular and precision-based approaches in the treatment of BED.
Keywords: binge eating disorder; dialectical behaviour therapy; emotion dysregulation; alexithymia; psychotherapy binge eating disorder; dialectical behaviour therapy; emotion dysregulation; alexithymia; psychotherapy

Share and Cite

MDPI and ACS Style

Zompa, L.; Cassioli, E.; Rossi, E.; Cordasco, V.Z.; Caiati, L.; Lucarelli, S.; Giunti, I.; Lazzeretti, L.; D’Anna, G.; Dei, S.; et al. Group Dialectical Behavior Therapy for Binge Eating Disorder: Emotion Dysregulation and Alexithymia as Mediators of Symptom Improvement. Nutrients 2025, 17, 2003. https://doi.org/10.3390/nu17122003

AMA Style

Zompa L, Cassioli E, Rossi E, Cordasco VZ, Caiati L, Lucarelli S, Giunti I, Lazzeretti L, D’Anna G, Dei S, et al. Group Dialectical Behavior Therapy for Binge Eating Disorder: Emotion Dysregulation and Alexithymia as Mediators of Symptom Improvement. Nutrients. 2025; 17(12):2003. https://doi.org/10.3390/nu17122003

Chicago/Turabian Style

Zompa, Luca, Emanuele Cassioli, Eleonora Rossi, Valentina Zofia Cordasco, Leda Caiati, Stefano Lucarelli, Ilenia Giunti, Lisa Lazzeretti, Giulio D’Anna, Simona Dei, and et al. 2025. "Group Dialectical Behavior Therapy for Binge Eating Disorder: Emotion Dysregulation and Alexithymia as Mediators of Symptom Improvement" Nutrients 17, no. 12: 2003. https://doi.org/10.3390/nu17122003

APA Style

Zompa, L., Cassioli, E., Rossi, E., Cordasco, V. Z., Caiati, L., Lucarelli, S., Giunti, I., Lazzeretti, L., D’Anna, G., Dei, S., Cardamone, G., Ricca, V., Rotella, F., & Castellini, G. (2025). Group Dialectical Behavior Therapy for Binge Eating Disorder: Emotion Dysregulation and Alexithymia as Mediators of Symptom Improvement. Nutrients, 17(12), 2003. https://doi.org/10.3390/nu17122003

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