Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany.
Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Int J Eat Disord. 2019 May;52(5):520-529. doi: 10.1002/eat.23024. Epub 2019 Jan 28.
Bulimia nervosa (BN) and binge-eating disorder (BED) are associated with poorly controlled approach behavior toward food resulting in binge eating. Approach bias modification (ABM) may reduce these automatic action tendencies (i.e., approach bias) toward food and may thus decrease binge eating and related symptoms.
A total of 56 patients with BN/BED participated in this double-blind, randomized controlled trial (RCT) comparing real and sham ABM. The real ABM condition adopted an implicit learning paradigm in which participants were trained to show avoidance behavior in response to food cues. Participants in the sham condition used a similar task but were not trained to avoid food cues. Both conditions comprised 10 training sessions within 4 weeks.
Participants in both groups experienced significant reductions in binge eating, eating disorder symptoms, trait food craving, and food cue reactivity. Real ABM tended to result in greater reductions in eating disorder symptoms than sham ABM. Food intake, approach bias, and attention bias toward food did not change.
This is the first RCT on ABM in eating disorders. The findings provide limited support for the efficacy of ABM in BN/BED and pose questions regarding its active ingredients and its usefulness as a stand-alone treatment for eating disorders.
神经性贪食症（BN）和暴食症（BED）与对食物的控制不佳的趋近行为有关，导致暴食。趋近偏差修正（ABM）可以减少这些对食物的自动行为倾向（即趋近偏差），从而减少暴食和相关症状。
共有 56 名 BN/BED 患者参与了这项双盲、随机对照试验（RCT），比较了真实和假 ABM。真实 ABM 条件采用内隐学习范式，参与者接受训练以对食物线索表现出回避行为。假条件组使用类似的任务，但未接受回避食物线索的训练。两组均在 4 周内进行 10 次训练。
两组参与者的暴食、饮食失调症状、特质食物渴求以及食物线索反应均显著减少。真实 ABM 组的饮食失调症状改善程度优于假 ABM 组。食物摄入量、趋近偏差和对食物的注意偏向没有改变。
这是第一项关于饮食障碍中 ABM 的 RCT。研究结果有限地支持了 ABM 在 BN/BED 中的疗效，并对其有效成分及其作为饮食障碍的独立治疗方法的实用性提出了质疑。
