123 Dialectical behavior therapy and cognitive behavior therapy in individuals with binge eating disorder: what works for whom? 5 presentations on difficulties in identifying feelings to CBT+ or DBT-BED. Overall, findings rather consistently indicate that the association between a significant moderator and outcome is stronger for DBT-BED than CBT+ and that, for low values of the moderator variable, the difference in binge eating outcome between DBT-BED and CBT+ is greater than for high values of the moderator variable. Based on the theoretical models of DBT-BED and CBT+, we expected that patients with distinct emotion regulation problems would demonstrate greater symptom improvements in DBT-BED, while patients with distinct problems in areas related to dieting, shape/weight or self-esteem, would do better in CBT+. Findings partially and tentatively support the first hypothesis: whereas levels of negative affect (depression and anxiety) and emotional dysregulation did not show a moderator effect, suggesting that these ‘DBT-characteristics’ do not uniquely influence outcomes, individuals with BED and higher levels of emotional eating or difficulties identifying feelings may show better binge eating outcome in DBT-BED at EOT and FU respectively. Also, lower emotional eating and difficulties identifying feelings signaled better outcome in CBT+ than in DBT-BED. This may imply that treatment-specific factors (i.e. emotion regulation skills in DBT-BED) influence outcome for specific subgroups. Remarkably, emotional eating showed a large interaction effect at EOT (IRR = 3.27), while all other effects were (very) small. Future studies are needed to replicate this cross pattern, and to determine the turning point. Our hypotheses regarding individuals with BED and greater difficulties in areas related to the CBT-model were not supported. Indeed, lower (instead of higher) overvaluation of body shape/weight and lower (instead of higher) shape concerns predicted greater reductions in OBE frequency in CBT+ than DBT-BED at EOT. Also, individuals with higher self-esteem (meaning lower scores on EDI-3 low self-esteem), showed greater reductions in OBE frequency in CBT+ than DBT-BED. Yet, levels of weight concerns and restraint did not moderate binge eating outcome, implying that these characteristics do not uniquely influence outcome. Notably, in line with previous studies (Anderson et al., 2020; Blood et al., 2020; Grilo et al., 2011), levels of dietary restraint are low (mean = 1.61, SD = 1.36). This may add to findings that question the importance of restraint in the maintenance of binge eating in BED and suggest that other factors may play a more critical role (Dakanalis et al., 2015). As noted by others (e.g. Grilo et al., 2019; Lydecker et al., 2017), manifestations of body-image disturbance in BED are complex. The current findings illustrate this. First, while CBT+ focusses particularly on overvaluation, lower instead of higher values of overvaluation and of shape concerns predicted greater reductions in OBE frequency in CBT+ than in DBT-BED at EOT, and differences between treatments were smaller for
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