Cue exposure in the treatment of resistant bulimia nervosa.
OBJECTIVE
It was hypothesized that binge eating (bulimia nervosa [BN]) may be caused by the anticipatory and immediate anxiety associated with certain types of food. Consequently, an extinction schedule should reduce binge eating.


METHODS
Cue exposure was carried out with 6 bulimic women who had responded poorly or not at all to the usual pharmacologic or cognitive-behavioral treatments.


RESULTS
Binge eating and vomiting were almost totally suppressed in the 6 patients. Symptom suppression was maintained at two follow-ups, one at 4-20 months and another at 2.5-3 years.


CONCLUSIONS
Cue exposure may be effective with BN that is resistant to conventional treatments. The anxiety associated with food plays an important role in provoking and/or maintaining binge eating. Motivation to change is likely to be an important mediator.
Toro
J
J
Servei de Psiquiatria i Psicologia Infantil i Juvenil, Hospital Clínic Universitari, University of Barcelona, Barcelona, Spain. jtoro@clinic.ub.es
Cervera
M
M
Feliu
M H
MH
Garriga
N
N
Jou
M
M
Martinez
E
E
Toro
E
E
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology / Q000628:therapy; D001143:Arousal; D002032:Bulimia / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D003463:Cues; D003887:Desensitization, Psychologic / Q000379:methods*; D004038:Diet, Reducing / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D005518:Food Preferences / Q000523:psychology; D006801:Humans; D007389:Internal-External Control; D009042:Motivation; D010043:Outcome and Process Assessment, Health Care; D012307:Risk Factors; D055502:Secondary Prevention; D017211:Treatment Failure