A Randomised Controlled Comparison of Second-Level Treatment Approaches for Treatment-Resistant Adults with Bulimia Nervosa and Binge Eating Disorder: Assessing the Benefits of Virtual Reality Cue Exposure Therapy

Eur Eat Disord Rev. 2017 Nov;25(6):479-490. doi: 10.1002/erv.2538. Epub 2017 Aug 14.

Abstract

A question that arises from the literature on therapy is whether second-level treatment is effective for patients with recurrent binge eating who fail first-level treatment. It has been shown that subjects who do not stop binge eating after an initial structured cognitive-behavioural treatment (CBT) programme benefit from additional CBT (A-CBT) sessions; however, it has been suggested that these resistant patients would benefit even more from cue exposure therapy (CET) targeting features associated with poor response (e.g. urge to binge in response to a cue and anxiety experienced in the presence of binge-related cues). We assessed the effectiveness of virtual reality-CET as a second-level treatment strategy for 64 patients with bulimia nervosa and binge eating disorder who had been treated with limited results after using a structured CBT programme, in comparison with A-CBT. The significant differences observed between the two groups at post-treatment in dimensional (behavioural and attitudinal features, anxiety, food craving) and categorical (abstinence rates) outcomes highlighted the superiority of virtual reality-CET over A-CBT. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Keywords: binge eating disorders; bulimia nervosa; cue exposure; treatment; virtual reality.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anxiety / psychology
  • Binge-Eating Disorder / psychology
  • Binge-Eating Disorder / therapy*
  • Bulimia Nervosa / psychology
  • Bulimia Nervosa / therapy*
  • Cognitive Behavioral Therapy / methods*
  • Craving
  • Cues*
  • Female
  • Humans
  • Male
  • Treatment Outcome
  • Virtual Reality Exposure Therapy*