Novel approaches to tackling emotional loss of control of eating across the weight spectrum

Abstract

Emotional overeating is a process that is particularly relevant to people within the binge spectrum of eating disorders. Approximately a third of people with overweight share this phenotype. In addition, this behaviour may occur in neurodevelopmental disorders (attention-deficit hyperactivity disorder (ADHD)) and other psychiatric disorders. The biopsychosocial underpinnings of emotional eating include a genetic vulnerability to a higher weight and various cognitive and emotional traits. The environment also plays a key role. For example, the commodification of food and beauty and exposure to weight stigma, unpleasant eating experiences and general adversity can set the scene. The majority of people with binge-eating disorder do not seek treatment (perhaps related to internalised stigma and shame). Hence opportunities for early intervention and secondary prevention are lost. Most guidelines for binge-eating disorder (based on the limited available research) recommend forms of cognitive psychotherapies and antidepressants. However, novel treatments that target underlying mechanisms are in development. These include interventions to improve emotional regulation and inhibitory control using neuromodulation and/or brain training. New technologies have been applied to talking therapies, including apps which can offer ‘just-in-time interventions’ or virtual reality or avatar work which can deliver more personalised interventions using complex scenarios. Drugs used for the treatment of ADHD, psychiatric and metabolic disorders may have the potential to be repurposed for binge-eating disorder. Thus, this is an area of rapid change with novel solutions being applied to this problem.

Feasibility and acceptability of a digital tele‐guided intervention targeting components of the addictive appetite model for bulimia nervosa and binge‐eating disorder in Korea

“…Binge eating was triggered by food cues or cues that could become related to negative affect in the model over the course of BN and BED (Chami et al, 2020). Novel treatments that target the components of the maintenance mechanisms are in development (Treasure et al, 2022) and showed improvements in inhibitory control (Chami et al, 2020; Keeler et al, 2022). However, CBT targeting multifactorial processes in the model remains untested in patients with BN and BED.…”