A research team from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London has explored the practicality of a new at-home treatment for binge eating disorder. The treatment involves using a gentle brain stimulation technique known as transcranial direct current stimulation (tDCS) along with a training program that focuses on changing unhelpful patterns of attention related to food.
The results, which were published in BJPsychOpen, suggest that this approach could offer a promising new option for treatment.
Binge eating disorder (BED) is a severe mental illness that can impact individuals of any age, gender, ethnicity, or background. Those with the disorder experience repeated episodes of losing control over their food consumption, eating large amounts of food in a brief period until they feel uncomfortably full. BED is often accompanied by anxiety and depression, and is associated with obesity and metabolic issues.
Innovative methods to address an unresolved issue
For the treatment of BED, psychological therapies are recommended, and approximately 50% of individuals undergoing treatment experience complete and long-lasting recovery.
Studies have indicated that self-regulation processes in the brain play a crucial role in perpetuating the cycle of binge eating, and new methods like tDCS and attention bias modification training (ABMT) are designed to address these processes.
TDCS works by altering the function of the brain’s prefrontal areas through the application of mild electrical stimulation to specific brain areas using electrodes placed on the s.ABMT, or attention bias modification training, helps people with BED improve their self-regulatory control by addressing unhelpful biases towards food cues. The training focuses on changing how individuals pay attention to high-calorie food cues. The TANDEM trial looked into the feasibility, acceptability, and potential effectiveness of using new tDCS devices for self-administered treatment at home, combined with ABMT, for BED. The trial involved 82 overweight or obese participants who were diagnosed with BED.
Ants were divided into four groups and received the following treatments:
- 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)
Reduced Binge Eating, Weight Loss, and Improvements in Mood
The group that received real tDCS with ABMT showed the most significant changes in binge eating behavior. Binge episodes were reduced from around 20 times a month on average at baseline.Between the start and the six-week follow-up, participants in the real tDCS with ABMT group reported losing approximately 3.5 to 4 kg. This was reflected in a reduction in the mean body mass index (BMI) of 1.28 points. In comparison, those who received ABMT with sham tDCS lost about 1.5 to 2 kg on average, resulting in a reduction in mean BMI of 0.52 points. The group that received ABMT only had negligible change in their weight, with a reduction in mean BMI of 0.07 points. The control group that received no treatment did not experience any change in eating behavior or weight loss.=”insertion_bottom”>
The group that received genuine tDCS with ABMT also experienced significant improvement in their mood from the beginning to the end of the study. There was no similar mood change reported in the group that received fake tDCS with ABMT or in the group that received ABMT alone. Additionally, there was no change in mood in the group that received no treatment at all.
Dr. Michaela Flynn, a Research Associate at King’s IoPPN and the primary author of the study, stated: “Current treatments for binge eating disorder are only effective for some individuals, and many require additional or alternative support to achieve wellness. Our study is the first to explore a new option for home-based treatment that offers”TDCS offers a new method for addressing binge eating disorder by targeting the brain patterns that contribute to loss of control around food. This approach helps individuals change their entrenched thinking and behavior related to food.
According to participants, they experienced a lighter mood, which may have contributed to reported changes in eating behavior and lasting weight loss even after treatment ended. The findings are promising, and researchers plan to further investigate this method with a larger group of participants.
Professor Ulrike Schmidt OBE, who is a Professor of Eating Disorders at King’s IoPPN and coauthor of the study, commented on the potential of this approach.Binge eating disorder is a frequently overlooked and distressing eating disorder, often accompanied by feelings of shame. The treatment we examined is delivered to the patient’s home, making it accessible to those who may struggle to attend in-person appointments. Historically, eating disorder services have not received funding to address binge eating disorder. The treatment we are discussing is relatively simple to administer, suggesting it could be widely implemented within the NHS.”
Professor Iain Campbell, Senior Research Fellow at King’s IoPPN, stated, “These promising clinical results will contribute to the improvement of treatment for The aim of this study is to explore the effects of neuromodulation on brain processes and to encourage further research in this area. It is recommended that future studies replicate these initial findings in a larger clinical trial with extended follow-up periods of more than six weeks. Additionally, the use of functional imaging and wearable technologies could provide valuable information on daily changes in physical activity, diet, mood, and other factors that may contribute to the therapeutic effects. It is also suggested that future studies explore the combination of tDCS with other treatments such as mindfulness or cognitive training techniques. This research was funded by the NaNational Institute of Health and Care Research (NIHR) Maudsley Biomedical Research Centre (BRC).
