Assessing The Effectiveness Of Attention Training Therapy In The Treatment Of Binge Eating Within Bulimia Nervosa And Binge Eating Disorder - A Randomised Controlled Trial

Abstract

Binge eating is a core symptom of both Bulimia Nervosa (BN) and Binge Eating Disorder (BED). Information processing theories of eating disorders propose that selective attention towards food stimuli may be a significant factor maintaining binge eating within these disorders. The Attention Training Therapy (ATT) program used in this RCT was originally designed as a treatment for social phobia. It was found to be as effective as CBT but with better outcomes in reducing fear of negative evaluation and self-focused attention. This program was modified to focus on binge eating by teaching individuals to shift their attention away from binge urges to the task at hand and towards thoughtful eating, which was hypothesized to reduce binge eating frequency. This study aimed to evaluate the efficacy of group-based manualised ATT program for individuals with BN or BED compared to a waitlist control condition. 48 females met DSM-5 criteria (BN = 41; BED = 7) and were randomly allocated to either group-ATT treatment (N = 27) or waitlist control (N = 21). All participants were assessed using a clinician-administered semi-structured interview and a battery of questionnaires at baseline, post-treatment and follow-up. Results at post-treatment and follow-up found no significant reduction in binge eating frequency between the groups. However, the treatment group reported significantly increased emotion regulation and impulse control, a reduced sense of negative beliefs/having ‘no control over their eating’ and in the clinical interview they also endorsed significantly fewer weight and shape concerns compared to the waitlist group. This study provides a unique contribution to the eating disorders treatment literature by examining the impact of modifying attention focus, an area not previously researched.