New home-administered treatment for binge eating disorder shows promising results

Researchers from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London have investigated the feasibility of a new home-administered treatment for binge eating disorder. The new treatment combines a gentle brain stimulation technique called transcranial direct current stimulation (tDCS) with a training program that targets unhelpful patterns of attention around food.

The findings, published in BJPsychOpen, indicate that this might be a welcome new avenue for treatment.

Binge eating disorder (BED) is a serious mental illness that can affect anyone of any age, gender, ethnicity or background. People with the disorder have recurring episodes of losing control over their food intake, consuming lots of food in a short period of time until they are uncomfortably full. BED is typically accompanied by anxiety and low mood and linked to obesity and metabolic complications.

New approaches to meet an unmet need

Psychological therapies are recommended for treatment of BED and about 50% of those who receive treatment achieve a full and lasting recovery.

Research has shown that self-regulatory processes in the brain are instrumental in maintaining the cycle of binge eating and innovative approaches such as tDCS and attention bias modification training (ABMT) aim to target these processes.

TDCS changes function in the prefrontal areas of the brain by applying a gentle electrical stimulation to carefully selected areas of the brain via electrodes placed on the scalp. ABMT improves self-regulatory control by correcting unhelpful biases towards food cues and training people with BED to change how they attend to high-calorie food cues.

TANDEM trial

New tDCS devices have been developed to enable self-administration at home. The TANDEM trial investigated whether the simultaneous delivery of at-home self-administered tDCS with ABMT is feasible, acceptable and potentially effective for the treatment of BED.

Researchers recruited 82 participants who were overweight or living with obesity and who met the criteria for BED diagnosis. Participants were allocated to one of four groups that received either:

• 10 sessions of at-home self-administered tDCS during ABMT

• 10 sessions of pretend (sham) tDCS with a headset that did not deliver electrical stimulation during ABMT,
• 10 sessions of ABMT only,
• No treatment (they remained on a waitlist for 8 weeks).

Less binge eating; weight loss and mood improvements

Changes to binge eating behavior were most pronounced in those who received real tDCS with ABMT. In this group, binge episodes were reduced from around 20 times a month on average at baseline to six times a month at follow-up six weeks later.

Participants in the real tDCS with ABMT group also reported that they lost approximately 3.5 to 4 kg between baseline and six-week follow-up (reduction in mean body mass index [BMI] of 1.28 points). In comparison, over the same period of time, those who received ABMT with sham tDCS reported that they lost about 1.5 to 2 kg on average (reduction in mean BMI of 0.52 points) and those who received ABMT only reported negligible change in their weight (reduction in mean BMI of 0.07 points). There was no change in eating behavior or weight loss in the no-treatment control group.