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Approach bias modification training in bulimia nervosa and binge-eating disorder: a pilot randomised controlled trial

Research output: Contribution to journalArticlepeer-review

Timo Brockmeyer, Hans Christoph Friederich, Carolyn Küppers, Sharmain Chowdhury, Louisa Harms, Jess Simmonds, Gemma Gordon, Rachel Potterton, Ulrike Schmidt

Original languageEnglish
Pages (from-to)520-529
Number of pages10
JournalInternational Journal of Eating Disorders
Issue number5
Early online date28 Jan 2019
Accepted/In press7 Jan 2019
E-pub ahead of print28 Jan 2019
PublishedMay 2019


King's Authors


Objective: 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. 

Method: 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. 

Results: 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. 

Discussion: 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.

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