The Sequential Binge, a New Therapeutic Approach for Binge Eating: A Pilot Study.
OBJECTIVE
A sizeable proportion of patients experiencing binge eating do not respond to cognitive behavioral therapy (CBT). We present the sequential binge (SB), a new behavioral intervention that complements CBT, and preliminary results of its effects. SB breaks up the binge into repeated identical sequences of eating separated by incremental pauses. This pattern of ingestion aims at facilitating boredom toward the ingested foods and at turning cognitive control away from binge food restriction. SB is hypothesized to reduce food intake during the binge and the number of daily binges.


METHODS
Prospective pilot study. Fifteen binging patients with previous unsuccessful intensive CBT were given SB as an adjunct to their treatment and were followed up for 16 weeks from admission. All patients were reassessed 47 weeks on average after discharge.


RESULTS
SB was associated with a 44% relative reduction in the planned food intake (p<0.001), a longer consecutive binge refractory period compared to regular binges (median: 48 hours versus 4 hours, p = 0.002) and an average relative reduction by 26% of binge number the day after each SB (p = 0.004). 47% of patients reached binge abstinence for four consecutive weeks 16 weeks after the first SB.


CONCLUSIONS
This case series shows promising evidence for the use of SB in patients with refractory binge eating. Further evaluation in a prospective randomized controlled trial would be justified.
CNRS, UMR5292, INSERM, U1028, Université Lyon 1, Université de Lyon, Neuroscience Research Center, Team Olfaction: from coding to memory, Lyon, F-69366, France.|Praxis, Ville-la-Grand, France.
Rémi
R
Neveu
Université Montpellier 1, Montpellier, France.|INSERM U 1058, Montpellier, France.|CHU Montpellier, Département d'information médicale, Montpellier, France.
Dorine
D
Neveu
Regional Eating Disorders Service, Greenlane Clinical Centre, Auckland, New Zealand.
Guillaume
G
Barbalat
Section of Eating Disorders (PO59), Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, United Kingdom.
Ulrike
U
Schmidt
University of Southern California, Los Angeles, CA, United States of America.|Interdepartmental Centre for Mind/Brain Sciences (CIMeC), University of Trento, Trento, Italy.
Giorgio
G
Coricelli
Hôpital du Vinatier, Bron, France.
Alain
A
Nicolas
D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D056912:Binge-Eating Disorder / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D004435:Eating; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D055815:Young Adult