A randomised controlled comparison of second-level treatment approaches for treatment-resistant adults with bulimia nervosa and binge eating disorder: assessing the benefits of virtual reality cue exposure therapy
Abstract
A question that arises from the literature on therapy is whether second-level treatment is effective for patients with recurrent binge eating who fail first-level treatment. It has been shown that subjects who do not stop binge eating after an initial structured cognitive-behavioural treatment (CBT) programme benefit from additional CBT (A-CBT) sessions; however, it has been suggested that these resistant patients would benefit even more from cue exposure therapy (CET) targeting features associated with poor response (e.g. urge to binge in response to a cue and anxiety experienced in the presence of binge-related cues). We assessed the effectiveness of virtual reality-CET as a second-level treatment strategy for 64 patients with bulimia nervosa and binge eating disorder who had been treated with limited results after using a structured CBT programme, in comparison with A-CBT. The significant differences observed between the two groups at post-treatment in dimensional (behavioural and attitudinal features, anxiety, food craving) and categorical (abstinence rates) outcomes highlighted the superiority of virtual reality-CET over A-CBT. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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- Authors
- Ferrer‐García, M., Gutiérrez‐Maldonado, J., Pla‐Sanjuanelo, J., Vilalta‐Abella, F., Riva, G., Clerici, M., Ribas‐Sabaté, J., Andreu‐Gracia, A., Fernandez‐Aranda, F., Forcano, L., Riesco, N., Sánchez, I., Escandón‐Nagel, N., Gomez‐Tricio, O., Tena, V., & Dakanalis, A.
- Affiliations
- Universitat de Barcelona (ES)
- IRCCS Istituto Auxologico Italiano (IT)
- University of Milano-Bicocca (IT)
- Hospital Universitari d'Igualada (ES)
- Department of Psychiatry University Hospital of Bellvitge‐IDIBELL and CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN)‐ISCIII Spain
- Instituto de Salud Carlos III (ES)
- Universidad Católica de Temuco (CL)
- Department of Psychiatry University Hospital Joan XXIII Spain
- Centro ABB Tarragona Spain
- University of Pavia (IT)
- Corresponding author
- Gutiérrez‐Maldonado, José
- ORCID
- Venue
- European Eating Disorders Review
- Publisher
- Wiley
- Published
- 2017-08-14
- Volume
- 25
- Issue
- 6
- Pages
- 479-490
- ISSN
- 1072-4133 (ISSN-L)
- 1099-0968
- OpenAlex
- W2747137660
- Cited by
- 142
- References
- 79
- Citations by year
- 2026: 10 · 2025: 9 · 2024: 7 · 2023: 4 · 2022: 13 · 2021: 16 · 2020: 61 · 2019: 10 · 2018: 10 · 2017: 1 · 2016: 1
- FWCI
- 27.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Eating Disorders Review (publishedVersion)
- PubMed (publishedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- Repositorio Académico de la Universidad Católica de Temuco (Universidad Católica de Temuco) (submittedVersion)
- Funders
- Ministerio de Ciencia e Innovación (PSI2011‐28801)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- bulimia nervosa, binge eating disorder, treatment-resistant eating disorders, food cravings, abstinence rates, anxiety
- MeSH terms
- Adult, Anxiety, Cues, Female, Humans, Male, Cognitive Behavioral Therapy, Treatment Outcome, Bulimia Nervosa, Binge-Eating Disorder, Virtual Reality Exposure Therapy, Craving
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