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We conducted a single\u2010arm pilot test of FoodSteps\u2010FI, a guided self\u2010help digital intervention for binge eating adapted for food insecurity, among adults with food insecurity, recurrent binge eating, and type 2 diabetes mellitus. Our aims were to test the feasibility and preliminary efficacy of FoodSteps\u2010FI delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Participants were 31 non\u2010pregnant, English\u2010speaking adults (\u2265\u200918\u2009years old) with self\u2010reported type 2 diabetes mellitus, recurrent binge eating (\u2265\u200912 episodes in the past 3\u2009months), and past 30\u2010day food insecurity who were interested in intervention and owned a smartphone with internet access. All participants received FoodSteps\u2010FI with messaging\u2010based coaching (~2\u00d7\/weekly) for 16\u2009weeks, and a weekly stipend. Participants completed assessments at mid\u2010intervention (8\u2009weeks) and post\u2010intervention (16\u2009weeks). Intent\u2010to\u2010treat analyses assessed feasibility and changes in clinical outcomes from baseline to post\u2010intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The trial demonstrated feasible recruitment, high study retention, and high intervention completion, adherence, and ratings of usability. Participants achieved improvements in binge eating, weight, past 30\u2010day food security status, eating concerns, shape concerns, weight concerns, eating disorder impairment, depressive symptoms, shame, and guilt. Nearly all participants rated the stipend as helpful for making behavior changes, but substantially fewer said it was sufficient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This pilot trial demonstrated the early promise of an adapted digital binge\u2010eating intervention for this population, and the need for future research on its effectiveness and implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/eat.70087","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T03:38:38Z","timestamp":1774323518000},"page":"1531-1542","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility and Preliminary Efficacy of a Guided Self\u2010Help Digital Intervention for Adults With Food Insecurity, Recurrent Binge Eating, and Type 2 Diabetes Mellitus: A Pilot Trial"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9736-8906","authenticated-orcid":false,"given":"Andrea K.","family":"Graham","sequence":"first","affiliation":[{"name":"Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Department of Medical Social Sciences Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6538-2562","authenticated-orcid":false,"given":"Rebecca L.","family":"Flynn","sequence":"additional","affiliation":[{"name":"Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Department of Medical Social Sciences Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4438-1816","authenticated-orcid":false,"given":"Isabel R.","family":"Rooper","sequence":"additional","affiliation":[{"name":"Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Department of Medical Social Sciences Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3331-9293","authenticated-orcid":false,"given":"Chidiebere","family":"Azubuike","sequence":"additional","affiliation":[{"name":"Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Department of Medical Social Sciences Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1677-0567","authenticated-orcid":false,"given":"Lindsay D.","family":"Lipman","sequence":"additional","affiliation":[{"name":"Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Department of Medical Social Sciences Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1003-2156","authenticated-orcid":false,"given":"Adrian","family":"Ortega","sequence":"additional","affiliation":[{"name":"Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Department of Preventive Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois 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