Neveu Rémi, Neveu Dorine, Barbalat Guillaume, Schmidt Ulrike, Coricelli Giorgio, Nicolas Alain
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.
PLoS One. 2016 Nov 10;11(11):e0165696. doi: 10.1371/journal.pone.0165696. eCollection 2016.
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.
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.
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.
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.
相当一部分暴饮暴食患者对认知行为疗法（CBT）无反应。我们提出了连续暴食法（SB），这是一种补充CBT的新行为干预方法，并展示了其效果的初步结果。SB将暴饮暴食分解为重复的相同进食序列，中间穿插逐渐增加的停顿。这种进食模式旨在促使对所摄入食物产生厌倦，并将认知控制从限制暴饮暴食的食物上转移开。据推测，SB可减少暴饮暴食期间的食物摄入量以及每日暴饮暴食的次数。
前瞻性试点研究。15名先前强化CBT治疗失败的暴饮暴食患者接受SB作为其治疗的辅助手段，并从入院开始随访16周。所有患者出院后平均47周进行重新评估。
SB与计划食物摄入量相对减少44%相关（p<0.001），与常规暴饮暴食相比，连续暴饮暴食不应期更长（中位数：48小时对4小时，p = 0.002），每次SB后第二天暴饮暴食次数平均相对减少26%（p = 0.004）。47%的患者在首次SB后16周连续四周实现了无暴饮暴食。
该病例系列显示了SB用于难治性暴饮暴食患者的有前景的证据。在一项前瞻性随机对照试验中进行进一步评估是合理的。
