Mechanisms of an Inhibitory Control Training to Reduce Binge Eating—The Randomized Controlled MIND BINGES Trial

OBJECTIVE: Psychotherapy is the first-line treatment for eating disorders (EDs), yet only about half of patients benefit long-term. Bulimia nervosa (BN), Binge-Eating-Disorder (BED), and non-underweight EDs with regular binge eating (> 2 binge-eating episodes per month within the last 3 months) (OSFED/UFED) form a transdiagnostic group characterized by elevated impulsivity. Inhibitory control training (ICT) approaches targeting impulsivity may be relevant. However, the role of feedback within ICT remains insufficiently understood. METHOD: MIND BINGES is a prospective randomized controlled proof-of-principle trial including 67 patients with regular binge-eating behavior. ICT was a food-modified antisaccade paradigm and comprised six sessions over 2 weeks. Patients were randomized to one of three conditions: (a) ICT with task performance feedback (TF), (b) ICT without feedback (TNF), or (c) control group without ICT. The primary outcome was the reduction of binge-eating frequency 4 and 12 weeks after ICT. Secondary outcomes included ED psychopathology, inhibitory control performance, impulsivity, and self-efficacy. RESULTS: All three groups reduced binge-eating frequency 4 and 12 weeks after ICT compared to the baseline. Four weeks after ICT, TF resulted in significantly greater reductions in binge-eating episodes compared to TNF and CG. These differences washed out after 12 weeks. Across secondary outcomes, all groups improved over time. DISCUSSION: Feedback contributes to short term reductions in binge-eating behavior and may inform development of mechanism-based interventions for ED. Further, reductions of the control group in binge-eating episodes imply unspecific effects of study participation and demand further investigation of low-threshold interventions. TRIAL REGISTRATION: DRKS00033023.