Approach bias modification in bulimic eating disorders

Abstract

Background: Obesity is considered a major public health concern and overeating as its most important cause. Automatic approach behaviour towards food that occurs early in information processing is thought to contribute to heightened food cue-reactivity, food craving and overeating. Bulimia nervosa (BN) and Binge Eating Disorder (BED) can be considered extreme forms of overeating. We tested whether Approach Bias Modification (ABM), a computerised cognitive training that targets biased approach behaviour towards food, can reduce binge-eating, food craving and intake in subclinical and clinical samples. Methods: First we tested ABM in an uncontrolled proof-of-concept study in a subclinical sample of n=30 people with high levels of food craving. In a subsequent randomised controlled trial, n=54 BN/BED patients underwent 10 sessions of either real or sham ABM. In both studies, eating disorder psychopathology, trait and cue-elicited food craving, and food intake was assessed before and after treatment. Findings: In the proof-of-concept study, ABM was associated with significant reductions in approach bias towards food, eating disorder psychopathology, trait and cue-elicited food craving. Data collection and analysis of the RCT will be finished by July 2017, final results will be presented at the conference. Preliminary analysis (n=35) showed that real CBM was superior to sham CBM in terms of reducing global eating disorder symptoms. Discussion: If successful, this novel intervention could be used as a cost-effective, easy-to-administer treatment module for reducing food craving and overeating in clinical and subclinical BN and BED.