Reducing Binge Eating Research Articles

Using virtual reality to train inhibitory control and reduce binge eating: A proof-of-concept study

ObjectiveOne reason for limited efficacy of treatments for binge eating disorder (BED) and bulimia nervosa (BN) is a failure to directly target deficits in inhibitory control (i.e., the ability to withhold a pre-potent response). Inhibitory control trainings (ICTs; computerized tasks meant to improve inhibitory control) have shown promise but appear not to be powerful enough to generalize to real-word eating behavior or engaging enough for to sustain long-term compliance. Delivering an ICT through virtual reality (VR) technology should increase intervention power because 3D imagery and actual real hand/arm movements are lifelike and may improve compliance because the VR environment is highly engaging. Thus, we created the first-ever VR-based ICT to test its initial feasibility, acceptability, and impact on binge eating. MethodWe recruited participants (N = 14) with once-weekly loss-of-control (LOC) eating to use the VR ICT daily, at home, for two weeks, and measured feasibility, acceptability and change in LOC eating at post-intervention and 2-week follow-up. ResultsThe VR ICT was feasible to construct and deploy, and demonstrated high acceptability and compliance (i.e., 86.8% of daily trainings completed). Users of the VR ICT experienced large decreases in LOC eating at post-intervention and 2-week follow-up. DiscussionResults from this initial pilot indicate that delivering ICT through VR is feasible, acceptable, and is associated with reductions in binge eating. Future study is warranted and should examine whether a VR ICT can serve as a useful adjunct to standard treatment for BN and BED.

Cognitive remediation-enabled cognitive behaviour therapy for obesity: a case series.

Despite varied treatment effects, weight recidivism is common and typically associated with the abandonment of prescribed weight management strategies. Literature suggests that difficulty with weight management is associated with deficits in executive functioning, in particular cognitive flexibility and response inhibition, the neurocognitive processes that are involved in goal-directed behaviours, such as dietary adherence. These processes are overlooked by mainstream weight loss programmes. The aim of the study was to assess the effectiveness of a cognitive remediation-enabled cognitive behaviour therapy (CR-CBT) in addressing the neurocognitive, psychological and behavioural correlates of weight loss. It was hypothesised that CR-CBT would improve cognitive flexibility and response inhibition, reduce binge eating, aid weight loss and improve metabolic health. Four adults with obesity (body mass index > 30kg/m2) received 7weeks of manualised CR-CBT and were assessed via a case series analysis at baseline, end of treatment and 3-month follow-up. Treatment included 3 weekly 90-min group-based behaviour weight loss sessions for 3weeks, followed by twice-weekly 50-min individualised CR-CBT sessions for 4weeks. Cognitive remediation-enabled cognitive behaviour therapy produced improvements in response inhibition and cognitive flexibility, and reductions in binge eating frequency, weight, and metabolic health readings between baseline and 3-month follow-up. This is the first study to assess the effectiveness of CR-CBT in the treatment of obesity. Preliminary indications of treatment success are discussed with respect to study limitations. In light of these results, we recommend further investigation via a randomised control trial (RCT). Level IV, case series.

Cannabidiol inhibits sucrose self-administration by CB1 and CB2 receptor mechanisms in rodents.

A growing number of studies suggest therapeutic applications of cannabidiol (CBD), a recently U.S. Food and Drug Administration (FDA)-approved medication for epilepsy, in treatment of many other neuropsychological disorders. However, pharmacological action and the mechanisms by which CBD exerts its effects are not fully understood. Here, we examined the effects of CBD on oral sucrose self-administration in rodents and explored the receptor mechanisms underlying CBD-induced behavioral effects using pharmacological and transgenic approaches. Systemic administration of CBD (10, 20, and 40 mg/kg, ip) produced a dose-dependent reduction in sucrose self-administration in rats and in wild-type (WT) and CB1-/- mice but not in CB2-/- mice. CBD appeared to be more efficacious in CB1-/- mice than in WT mice. Similarly, pretreatment with AM251, a CB1R antagonist, potentiated, while AM630, a selective CB2R antagonist, blocked CBD-induced reduction in sucrose self-administration, suggesting the involvement of CB1 and CB2 receptors. Furthermore, systemic administration of JWH133, a selective CB2R agonist, also produced a dose-dependent reduction in sucrose self-administration in WT and CB1-/- mice, but not in CB2-/- mice. Pretreatment with AM251 enhanced, while AM630 blocked JWH133-induced reduction in sucrose self-administration in WT mice, suggesting that CBD inhibits sucrose self-administration likely by CB1 receptor antagonism and CB2 receptor agonism. Taken together, the present findings suggest that CBD may have therapeutic potential in reducing binge eating and the development of obesity.

Controlling binge eating and weight: a treatment for binge eating disorder worth researching?

The majority of those who seek treatment for binge eating disorder also have accompanying obesity or overweight. The best available psychological treatments for binge eating disorder produce good and lasting outcomes with regard to control over eating but virtually no weight loss, yet control over eating and weight loss are both important and valued goals of those who seek treatment. We have devised a model of the processes maintaining both the binge eating and the overweight or obesity that occurs in many patients with binge eating disorder who seek treatment. The model draws on previous research findings to highlight and integrate the factors maintaining both the disordered eating and the accompanying overweight or obesity. We outline a new treatment based on the proposed model that explicitly addresses the twin goals of cessation of binge eating and weight loss in an integrated fashion. The proposed treatment incorporates and integrates elements from two previously tested evidence-based interventions, enhanced cognitive behavioural therapy for eating disorders shown to reduce binge eating and cognitive behaviour therapy of obesity, which produces weight loss. To meet a major challenge for the treatment of binge eating disorder (BED), we have proposed that an integrated treatment with the goals of addressing both binge eating and overweight or obesity is worth researching further. Should this treatment be successful, the goals of many patients who seek treatment for BED are more likely to be met. This brief report proposes a new approach to clinical practice to be researched further. The evidence on the basis of which the case is made is derived from Level 1: evidence obtained from at least one properly designed randomized controlled trial; systematic reviews and meta-analyses; and experimental studies.

IMPULS: Impulsivity-Focused Group Intervention to Reduce Binge Eating Episodes in Patients with Binge Eating Disorder – A Randomised Controlled Trial

Background: Impulsivity is a risk factor for binge eating disorder, and binge eating (BE) equates to impulsive eating behaviour. Hence, we developed IMPULS, a cognitive behavioural group intervention focusing on impulsive eating. Methods: We randomised 41 patients to the IMPULS group and 39 to the control group. The IMPULS group participated in the IMPULS treatment, while both groups completed weekly self-observations. We compared both groups concerning BE episodes in the past 4 weeks at the end of treatment (primary outcome). As secondary outcomes, we investigated eating pathology, depression, general impulsivity and body mass index (BMI) at the end of treatment and in a 3-month follow-up. Results: The primary outcome failed, because BE episodes in the past 4 weeks were reduced in both groups at the end of treatment. At follow-up, the IMPULS group showed further improvement, contrary to the control group. The BE days/episodes in the 2 months before were overall reduced in both groups. Eating pathology was reduced in the IMPULS group at the end of treatment and partly in both groups at the follow-up. Depression was only reduced in the IMPULS group. General impulsivity and BMI did not change. Conclusions: The IMPULS study has a negative primary outcome. However, secondary outcomes indicate that the IMPULS treatment might be promising, as BE, eating pathology and depression were reduced in the IMPULS group. The initially reduced BE in the control group might represent a short-term effect from the self-observations. General impulsivity and BMI might need a longer time or more intensive treatment to change.

Weight Change over the Course of Binge Eating Disorder Treatment: Relationship to Binge Episodes and Psychological Factors.

ObjectiveTreatment for Binge Eating Disorder (BED) – a condition associated with both excess adiposity and psychological distress – has not typically produced a significant weight loss despite reducing binge eating. Characterizing factors that promote or inhibit weight loss in individuals with co-occurring BED and obesity may help explain overall nonsignificant weight changes during treatment.Methods189 adults with BED participated in a randomized clinical trial evaluating the efficacy of 5M of cognitive behavioral therapy. Assessments included measured height and weight at baseline, midtreatment, end-of-treatment (EOT), and 6-month follow-up, the Eating Disorder Examination interview, and questionnaires.ResultsDuring treatment, there was a mean weight gain of 1.3±12.0 lbs. 22% of the sample lost ≥ 5 pounds and 25% of the sample gained ≥ 8 pounds. Results showed that baseline objective binge eating episodes (OBEs) predicted weight over treatment. Changes in weight were significantly positively related to concurrent changes in shape concern, weight concern, and disinhibition, but not binge eating episodes. Changes in OBEs from baseline to EOT were associated with changes in weight from EOT to follow-up.ConclusionsFurther investigation of eating behavior during BED treatment to understand the energy balance contributions to weight change or stability is warranted.

Virtual Reality as a Promising Strategy in the Assessment and Treatment of Bulimia Nervosa and Binge Eating Disorder: A Systematic Review.

Several lines of evidence suggest that Virtual Reality (VR) has a potential utility in eating disorders. The objective of this study is to review the literature on the use of VR in bulimia nervosa (BN) and binge eating disorder (BED). Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement for reporting systematic reviews, we performed a PubMed, Web of Knowledge and SCOPUS search to identify studies employing VR in the assessment and treatment of BN and BED. The following search terms were used: “virtual reality”, “eating disorders”, “binge eating”, and “bulimia nervosa”. From the 420 articles identified, 19 were selected, nine investigated VR in assessment and 10 were treatment studies (one case-report, two non-controlled and six randomized controlled trials). The studies using VR in BN and BED are at an early stage. However, considering the available evidence, the use of VR in the assessment of those conditions showed some promise in identifying: (1) how those patients experienced their body image; and (2) environments or specific kinds of foods that may trigger binge–purging cycle. Some studies using VR-based environments associated to cognitive behavioral techniques showed their potential utility in improving motivation for change, self-esteem, body image disturbances and in reducing binge eating and purging behavior.

Do emotion regulation difficulties when upset influence the association between dietary restraint and weight gain among college students?

Obesity is a significant public health concern that affects more than one-fifth of adolescents aged 12–19 in the United States. Theoretical models suggest that prolonged dietary restraint leads to binge-eating behaviors, which in turn increases individuals' risk for weight gain or obesity. Results from the literature indicate a potential role for negative urgency (the tendency to act rashly when distressed) as a mediating variable that explains the link between dietary restraint and binge-eating episodes. The current study tested short-term, prospective longitudinal associations among dietary restraint, binge eating, negative urgency, and weight gain among college students – a population at increased risk for the development of overweight and obesity. We hypothesized that dietary restraint and weight gain would be mediated by negative urgency and binge eating, but only among participants with overweight and obesity. College students (N = 227) completed the Eating Pathology Symptoms Inventory, UPPS-P Impulsivity Scale, and self-reported weight and height to calculate body mass index. Results showed that the association between dietary restraint and weight gain was mediated by negative urgency and binge eating, but only among participants with overweight and obesity. Our findings indicated that negative urgency might represent a mechanism that explains why dietary restraint leads to future binge-eating episodes and weight gain among college students with overweight and obesity. Results suggest that future treatment and prevention programs for overweight and obesity may benefit from incorporating strategies to improve emotion regulation as a way to reduce binge eating and to prevent additional weight gain among ‘at-risk’ populations.

Abstract MP004: Feasibility of an Appetite Awareness Intervention to Reduce Cardiovascular Disease Risk Factors and Binge Eating in African-American Women with Obesity

Background: Currently, 82.1% of African-American (AA) women are overweight or obese, and 48.9% of AA women have cardiovascular disease (CVD), the leading cause of death. Binge eating disorder (BED) is associated with severe obesity, psychiatric morbidity, and increased risk for CVD. Among AA women, BED is the most common eating disorder and has a 33% prevalence among those seeking weight loss. Since many adults with BED report becoming overweight after binge eating on a regular basis, intervening with individuals at risk to develop BED may be a viable strategy to prevent CVD and further weight gain. Purpose: To investigate the feasibility of an 8-week, community-based Appetite Awareness Training intervention among AA women who are overweight and obese reporting monthly binge eating episodes, and examine preliminary changes in CVD risk, eating self-efficacy, and binge eating between the intervention and control group. Methods: Eligible individuals were randomized to Appetite Awareness Treatment (AAT, n=16) or Wait-List Control (WLC, n=15) with the WLC receiving the AAT after 8-weeks of observation. The goal of Appetite Awareness Treatment is to help participants relearn their biological signals of hunger and satiety. Participants attend group sessions, and receive weekly homework to self-monitor their appetite cues. Assessments were conducted at 0 and 8 weeks at a community-based site. Linear mixed modeling was used to examine the baseline to 8-week changes between AAT and WLC groups on CVD risk factors (body weight, waist circumference, blood pressure) self-efficacy by Weight Efficacy Lifestyle Questionnaire (WEL), and binge eating by the Binge Eating Scale (BES). Results: The sample (N=31), had a mean age of 48.8 (SD±12.8), and a BMI of 33.7 kg/m 2 (SD±3.90). Retention was 87.5%, session attendance 65.9%, and homework completion 55%. There were significant group differences over time in the WEL score (p<.01, d=1.06), and the BES score (p<.001, d=.52) at the end of the intervention. The AAT group had an increase in the WEL score (+25.14±6.67), with no changes in the WLC group (-1.27±4.15). Additionally, the AAT group had a decrease in the BES score (-5.87±0.61), with no changes in the WLC group (0 ±0.01). There were no significant differences within and between groups in CVD risk factors. Conclusions: Our pilot trial results suggest that AAT is feasible in this population, with good retention, attendance, and preliminary evidence of a positive impact on eating self-efficacy, binge eating behaviors, and weight gain prevention. Future research should investigate the effectiveness of AAT to reduce binge eating and CVD risk in a larger sample and study with a longer duration.

Guided self-help group therapy for women with binge eating disorder

Background Self-help was found to be beneficial in terms of reduced binge eating, improved abnormal eating attitudes, and higher abstinence rates. They are typically brief and less costly compared with other therapies. Objectives The present study was designed to assess the outcome of guided self-help group therapy on female patients with binge eating disorder (BED). Patients and methods In the present experimental clinical trial, 27 female patients between 18 and 45 years of age diagnosed with BED were enrolled in guided self-help group therapy once weekly for 12 consecutive weeks. Prepsychometric and postpsychometric assessment was carried out to measure eating pathology, frequency of binge eating episodes, and self-esteem using Eating Disorder Examination, Symptom Checklist (SCL90-R), and Rosenberg’s self-Esteem Scale in addition to BMI. Results Patients showed a significant decrease in frequency of binge eating episodes (P=0.000), less over concern of body weight and shape, less BMI (P=0.000), and less psychological distress with no difference in self-esteem. Conclusion Guided self-help therapy is effective in reducing the severity of BED.

Teaching Intuitive Eating and Acceptance and Commitment Therapy Skills Via a Web-Based Intervention: A Pilot Single-Arm Intervention Study.

BackgroundMiddle-aged women are at risk of weight gain and associated comorbidities. Deliberate restriction of food intake (dieting) produces short-term weight loss but is largely unsuccessful for long-term weight management. Two promising approaches for the prevention of weight gain are intuitive eating (ie, eating in accordance with hunger and satiety signals) and the development of greater psychological flexibility (ie, the aim of acceptance and commitment therapy [ACT]).ObjectivesThis pilot study investigated the usage, acceptability, and feasibility of “Mind, Body, Food,” a Web-based weight gain prevention intervention prototype that teaches intuitive eating and psychological flexibility skills.MethodsParticipants were 40 overweight women (mean age 44.8 [standard deviation, SD, 3.06] years, mean body mass index [BMI] 32.9 [SD 6.01] kg/m2, mean Intuitive Eating Scale [IES-1] total score 53.4 [SD 7.46], classified as below average) who were recruited from the general population in Dunedin, New Zealand. Module completion and study site metrics were assessed using Google Analytics. Use of an online self-monitoring tool was determined by entries saved to a secure online database. Intervention acceptability was assessed postintervention. BMI, intuitive eating, binge eating, psychological flexibility, and general mental and physical health were assessed pre- and postintervention and 3-months postintervention.ResultsOf the 40 women enrolled in the study, 12 (30%) completed all 12 modules (median 7.5 [interquartile range, IQR, 2-12] modules) and 4 (10%) used the self-monitoring tool for all 14 weeks of the intervention period (median 3 [IQR 1-9] weeks). Among 26 women who completed postintervention assessments, most women rated “Mind, Body, Food” as useful (20/26, 77%), easy to use (17/25, 68%) and liked the intervention (22/25, 88%). From pre- to postintervention, there were statistically significant within-group increases in intuitive eating (IES-2 total score P<.001; all IES-2 subscale scores: P ≤.01), psychological flexibility (P=.01), and general mental health (P<.001) as well as significant decreases in binge eating (P=.01). At the 3-month follow-up, IES-2 improvements were maintained, and there were further improvements in binge eating (P<.001) and general mental health (P=.03), and a marginal yet nonsignificant tendency for further improvement in psychological flexibility (P=.06). There were no significant within-group changes in BMI from pre- to postintervention and postintervention to 3-month follow-up (P=.46 and P=.93, respectively).ConclusionsThe “Mind, Body, Food” prototype Web-based intervention is appealing to middle-aged women and may be a useful tool to help women learn intuitive eating and ACT skills, reduce binge eating, and maintain weight over 3 months. Further work to improve the user experience and engagement is required before testing the online intervention in a randomized controlled trial.

Tratamientos actuales del trastorno por atracón

Introducción: a pesar de que el trastorno por atracón (ta) constituye un importante problema de salud, menos de la mitad de quienes lo padecen reciben tratamiento. Objetivo: revisar la literatura reciente sobre las intervenciones llevadas a cabo en casos de ta. Método: con el fin de llevar a cabo la presente revisión narrativa, se han consultado las bases de datos Pubmed, Medline y Scielo. Solo se eligieron artículos en revistas indexadas en la Web of Science. La literatura revisada corresponde a los artículos más citados publicados en el período temporal que abarca desde el 2010 hasta el 2015. Resultados y conclusiones: los resultados muestran que las intervenciones más utilizadas son las de índole psicológica, entre las cuales se destacan la terapia cognitivo-conductual y la terapia interpersonal, recomendada esta última en pacientes con patología más severa. La terapia de conducta de pérdida de peso es menos eficaz al no reducir los atracones, por lo que no constituye el tratamiento de elección. Aunque algunos antidepresivos y antiepiléticos han mostrado cierta utilidad para reducir los atracones, el peso y patologías comórbidas, no hay evidencia de que la intervención farmacológica por sí sola sea más eficaz que la psicológica, ni de que mejore los resultados de la segunda cuando ambos se aplican conjuntamente.

Binge eating in bariatric surgery candidates: The role of insecure attachment and emotion regulation

Binge eating has a high prevalence among bariatric patients and is associated with post-surgical weight gain. This study examined the potential mediating role of emotion regulation difficulties in the relation between attachment insecurity and binge eating among this population. Participants were 1388 adult pre-bariatric surgery candidates from an accredited bariatric surgery assessment centre in Toronto, Ontario. Participants completed measures of psychological functioning, including attachment style and emotion regulation. Mediation analyses revealed that difficulties with emotion regulation mediated a positive association between insecure-anxious attachment and binge eating. An insecure-avoidant attachment was found to have a non-significant association with binge eating when examining the total effect. However, when difficulties with emotion regulation were controlled for in the model to examine its role as a mediator, this association became significant, and emotion regulation difficulties also mediated the relationship between attachment avoidance and binge eating. These findings suggest that difficulties in emotion regulation may be an important clinical issue to address in order to reduce binge eating in adult bariatric surgery candidates.

Dialectical behavior therapy skills training reduces binge eating among patients seeking weight-management services: preliminary evidence.

Dialectical behavior therapy skills training reduces binge eating among patients seeking weight-management services: preliminary evidence.

Self-compassion training for binge eating disorder: a pilot randomized controlled trial.

The present pilot study sought to compare a compassion-focused therapy (CFT)-based self-help intervention for binge eating disorder (BED) to a behaviourally based intervention. Forty-one individuals with BED were randomly assigned to 3 weeks of food planning plus self-compassion exercises; food planning plus behavioural strategies; or a wait-list control condition. Participants completed weekly measures of binge eating and self-compassion; pre- and post-intervention measures of eating disorder pathology and depressive symptoms; and a baseline measure assessing fear of self-compassion. Results showed that: (1) perceived credibility, expectancy, and compliance did not differ between the two interventions; (2) both interventions reduced weekly binge days more than the control condition; (3) the self-compassion intervention reduced global eating disorder pathology, eating concerns, and weight concerns more than the other conditions; (4) the self-compassion intervention increased self-compassion more than the other conditions; and (5) participants low in fear of self-compassion derived significantly more benefits from the self-compassion intervention than those high in fear of self-compassion. Findings offer preliminary support for the usefulness of CFT-based interventions for BED sufferers. Results also suggest that for individuals to benefit from self-compassion training, assessing and lowering fear of self-compassion will be crucial. Individuals with BED perceive self-compassion training self-help interventions, derived from CFT, to be as credible and as likely to help as behaviourally based interventions. The cultivation of self-compassion may be an effective approach for reducing binge eating, and eating, and weight concerns in individuals with BED. Teaching individuals with BED CFT-based self-help exercises may increase their self-compassion levels over a short period of time. It may be important for clinicians to assess and target clients' fear of self-compassion for clients to benefit from self-compassion training interventions.

Culturally adapted cognitive behavioral guided self-help for binge eating: a feasibility study with Mexican Americans.

Objective was to test feasibility and preliminary efficacy of a culturally adapted cognitive-behavioral self-help program to treat binge eating and related problems in Mexican Americans. Participants were 31 women recruited from the Los Angeles area and diagnosed with binge eating disorder, recurrent binge eating, or bulimia nervosa. Participants completed a culturally adapted version of a CBT-based self-help program with 8 guidance sessions over a 3-month period. Treatment efficacy was evaluated in terms of binge eating, psychological functioning, and weight loss. Intent-to-treat analyses revealed 35.5% abstinence from binge eating at posttreatment and 38.7% diagnostic remission. Results indicated significant pretreatment to posttreatment improvement on distress level, BMI, eating disorder psychopathology, and self-esteem. Satisfaction with the program was high. Findings demonstrate that the program is acceptable, feasible, and efficacious in reducing binge eating and associated symptoms for Mexican American women. Study provides "proof of concept" for implementation of culturally adapted forms of evidence-based programs.

GS 455534 selectively suppresses binge eating of palatable food and attenuates dopamine release in the accumbens of sugar-bingeing rats

Binge eating palatable foods has been shown to have behavioral and neurochemical similarities to drug addiction. GS 455534 is a highly selective reversible aldehyde dehydrogenase 2 inhibitor that has been shown to reduce alcohol and cocaine intake in rats. Given the overlaps between binge eating and drug abuse, we examined the effects of GS 455534 on binge eating and subsequent dopamine release. Sprague-Dawley rats were maintained on a sugar (experiment 1) or fat (experiment 2) binge eating diet. After 25 days, GS 455534 was administered at 7.5 and 15 mg/kg by an intraperitoneal injection, and food intake was monitored. In experiment 3, rats with cannulae aimed at the nucleus accumbens shell were maintained on the binge sugar diet for 25 days. Microdialysis was performed, during which GS 455534 15 mg/kg was administered, and sugar was available. Dialysate samples were analyzed to determine extracellular levels of dopamine. In experiment 1, GS 455534 selectively decreased sugar intake food was made available in the Binge Sugar group but not the Ad libitum Sugar group, with no effect on chow intake. In experiment 2, GS 455534 decreased fat intake in the Binge Fat group, but not the Ad libitum Fat group, however, it also reduced chow intake. In experiment 3, GS 455534 attenuated accumbens dopamine release by almost 50% in binge eating rats compared with the vehicle injection. The findings suggest that selective reversible aldehyde dehydrogenase 2 inhibitors may have the therapeutic potential to reduce binge eating of palatable foods in clinical populations.

A Brief Strategic Therapy Protocol for Binge Eating Disorder

BackgroundObesity and being overweight are often associated with Binge Eating Disorder (BED). Cognitive-Behavioral Therapy (CBT) has shown solid results in reducing binge eating, but it does not traditionally encourage weight loss. Since Brief Strategic Therapy (BST) has shown to be effective in treating obese people suffering from Binge Eating Disorder (BED), our objective is to compare the BST protocol as an alternative and/or integrative treatment to the traditional Cognitive-Behavioral Therapy, for inpatient and telephone-based outpatient treatment. MethodA two arm randomized controlled clinical trial including 6, 12 and 18 months post-treatment follow up is proposed. 60 participants meeting criteria for obesity and BED will be recruited from a single clinical center (Saint Joseph Hospital - Istituto Auxologico Italiano IRCCS) and randomly allocated in the CBT or BST group. The primary end point is the global change of patients’ progress score (Outcome Questionnaire - OQ 45.2), while the secondary outcome measures are patients’ weekly binge episodes and weight loss. Data will be collected before and after hospitalization (after 1 month) as well as at 6, 12 and 18 months from the end of the in-hospital treatment. Data at follow-up time points will be collected through tele- sessions. ConclusionThe present study represents the first randomized controlled trial aimed at comparing the effectiveness of BST with the gold standard CBT. These findings will advance current knowledge in both treatment for BED and telecommunication providing distant clinical healthcare.

Amelioration of binge eating by nucleus accumbens shell deep brain stimulation in mice involves D2 receptor modulation.

Hedonic overconsumption contributing to obesity involves altered activation within the mesolimbic dopamine system. Dysregulation of dopamine signaling in the nucleus accumbens shell (NAS) has been implicated in reward-seeking behaviors, such as binge eating, which contributes to treatment resistance in obesity (Wise, 2012). Direct modulation of the NAS with deep brain stimulation (DBS), a surgical procedure currently under investigation in humans for the treatment of major depression, obsessive-compulsive disorder, and addiction, may also be effective in ameliorating binge eating. Therefore, we examined the ability of DBS of the NAS to block this behavior in mice. c-Fos immunoreactivity was assessed as a marker of DBS-mediated neuronal activation. NAS DBS was found to reduce binge eating and increased c-Fos levels in this region. DBS of the dorsal striatum had no influence on this behavior, demonstrating anatomical specificity for this effect. The dopamine D2 receptor antagonist, raclopride, attenuated the action of DBS, whereas the D1 receptor antagonist, SCH-23390, was ineffective, suggesting that dopamine signaling involving D2 receptors underlies the effect of NAS DBS. To determine the potential translational relevance to the obese state, chronic NAS DBS was also examined in diet-induced obese mice and was found to acutely reduce caloric intake and induce weight loss. Together, these findings support the involvement of the mesolimbic dopamine pathways in the hedonic mechanisms contributing to obesity, and the efficacy of NAS DBS to modulate this system.

A double-blind, randomized pilot trial of chromium picolinate for binge eating disorder: Results of the Binge Eating and Chromium (BEACh) Study

ObjectiveChromium treatment has been shown to improve mood, appetite, and glucose regulation in various psychiatric and medical patient populations. The authors propose that chromium may be useful in the treatment of binge eating disorder (BED). MethodTwenty-four overweight adults with BED were enrolled in a 6-month double-blind placebo-controlled trial and randomly assigned to receive either 1000mcg chromium/day (“high dose”; n=8) or 600mcg chromium/day (“moderate dose”; n=9) as chromium picolinate or placebo (n=7). Mixed linear regression models were used to estimate mean change in binge frequency and related psychopathology, weight, symptoms of depression, and fasting glucose. ResultsFasting glucose was significantly reduced in both chromium groups compared to the placebo group; similarly, numerically, but not significantly, greater reductions in binge frequency, weight, and symptoms of depression were observed in those treated with chromium versus placebo, although statistical power was limited in this pilot trial. For fasting glucose, the findings suggest a dose response with larger effects in the high dose compared to moderate dose group. ConclusionThese initial findings support further larger trials to determine chromium's efficacy in maintaining normal glucose regulation, reducing binge eating and related psychopathology, promoting modest weight loss, and reducing symptoms of depression in individuals with BED. Studies designed to link the clinical effects of chromium with changes in underlying insulin, serotonin, and dopamine pathways may be especially informative. If efficacious, chromium supplementation may provide a useful, low-cost alternative to or augmentation strategy for selective serotonin reuptake inhibitors, which have partial efficacy in BED. ClinicalTrials.gov NCT00904306.