Exploring expectations for a digital intervention for binge eating among individuals experiencing food insecurity.

Food insecurity is strongly associated with adverse health outcomes and eating disorder behaviors, including binge eating. Individuals from under-resourced communities, who disproportionately experience food insecurity, often face substantial barriers to accessing eating disorder care. Digital interventions present a promising avenue to reduce disparities in treatment access, but their success depends on how well they align with the expectations of intended users. This study explored the motivations and expectations of treatment-seeking individuals with food insecurity who presented to FoodSteps, a digital intervention for binge eating. Semi-structured interviews were conducted with 124 participants across two trials. Using thematic analysis, we identified four themes related to participants' motivations for engagement and expectations for the intervention. First, participants were drawn to FoodSteps because it aligned with their personal health goals, including reducing binge eating, managing weight, and developing healthy eating patterns. Many sought greater insight into their behaviors, coping strategies for triggers, and accountability through support from a coach. Second, participants described FoodSteps as their first opportunity to access specialized care for binge eating, noting that prior treatment-seeking was often hindered by structural barriers. Third, digital delivery was viewed as especially appealing due to its accessibility, convenience, and affordability. Finally, participants highlighted shame surrounding binge eating as both a barrier to prior help-seeking and a motivator for engaging with this digital intervention. Overall, findings suggest that individuals experiencing food insecurity are motivated to engage with digital interventions that are supportive, accessible, and closely aligned with their personal health goals.