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Behavioral treatments for psychological disorders characterized by reward-driven maladaptive behaviors (e.g., substance use disorder, eating disorders, behavioral addictions) primarily seek to reduce hyper-reward response to disorder-specific stimuli. Suboptimal outcomes for these treatments highlight the need to also target hypo-reward response to day-to-day life activities. The present study sought to conduct an initial test of a novel behavioral treatment, Reward Re-Training (RRT) to target hyper- and hypo-reward response in individuals with binge eating. Individuals with binge eating (N = 23) were randomly assigned to either 10 weeks of outpatient, group-based RRT treatment or a waitlist control. RRT was found to be feasible and acceptable, demonstrated large impacts on both hypo- and hyper-reward response (measured by self-report (pre-to post-treatment η

Objective: One reason for limited efficacy of treatments for binge eating disorder (BED) and bulimia nervosa (BN) is a failure to directly target deficits in inhibitory control (i.e., the ability to withhold a pre-potent response). Inhibitory control trainings (ICTs; computerized tasks meant to improve inhibitory control) have shown promise but appear not to be powerful enough to generalize to real-word eating behavior or engaging enough for to sustain long-term compliance. Delivering an ICT through virtual reality (VR) technology should increase intervention power because 3D imagery and actual real hand/arm movements are lifelike and may improve compliance because the VR environment is highly engaging. Thus, we created the first-ever VR-based ICT to test its initial feasibility, acceptability, and impact on binge eating.Method: We recruited participants (N = 14) with once-weekly loss-of-control (LOC) eating to use the VR ICT daily, at home, for two weeks, and measured feasibility, acceptability and change in LOC eating at postintervention and 2-week follow-up.Results: The VR ICT was feasible to construct and deploy, and demonstrated high acceptability and compliance (i. e., 86.8% of daily trainings completed). Users of the VR ICT experienced large decreases in LOC eating at postintervention and 2-week follow-up.Discussion: Results from this initial pilot indicate that delivering ICT through VR is feasible, acceptable, and is associated with reductions in binge eating. Future study is warranted and should examine whether a VR ICT can serve as a useful adjunct to standard treatment for BN and BED.

Emotion-focused treatments are generally efficacious for improving emotion regulation and consequently, improving clinical symptoms across numerous disorders. However, emotion-focused treatment approaches often contain numerous treatment components, limiting our ability to identify which are most efficacious. As such, the current pilot study sought to isolate three components common across a range of emotion-focused treatments (i.e. emotional awareness, emotion down-regulation, and distress tolerance) and test the impact of each component on (1) emotion regulation and (2) emotional eating behavior. Adults (N = 76) who reported four or more emotional eating episodes in the past month were assigned to attend a one-time, three-hour workshop focused on either awareness, down-regulation or tolerance of emotions, and were subsequently evaluated at one-week and two-weeks follow-up. All groups experienced equivalent improvements in emotional eating at two-weeks follow-up (F [1.47, 85.38 ] = 7.60, p

Emotion dysregulation is a known risk factor for a variety of maladaptive eating behaviors, including emotional eating (Crockett, Myhre, & Rokke, 2015; Lavender et al., 2015). New passive sensing technologies offer the prospect of detecting emotion dysregulation in real-time through measurement of heart rate variability (HRV), a transdiagnostic bio-signal of emotion regulation, which may in turn signal risk of engaging in a maladaptive eating behavior. In the current study, our primary aim was to test the hypothesis that momentary changes in HRV can be used to detect risk of experiencing an emotional eating episode in an ecologically valid setting using a wrist worn sensor with acceptable classification accuracy. Participants were 21 adults with clinically significant emotional eating behaviors. Participants wore the Empatica E4 wrist-sensor and tracked all emotional eating episodes using ecological momentary assessment for four weeks. Time and frequency domain features of HRV were extracted in the 30-min period preceding emotional eating episodes and control cases (defined as the 30 min prior to an EMA survey that did not contain an emotional eating episode). Support vector machine (SVM) learning models were implemented using time domain and frequency domain features. SVM models using frequency domain features achieved the highest classification accuracy (77.99%), sensitivity (78.75%), and specificity (75.00%), consistent with standards deemed acceptable for the prediction of event-level health behavior. SVM models using time domain features still performed above chance, though were less accurate at classifying episodes (accuracy 63.48%, sensitivity 62.68%, and specificity 70.00%) and did not meet acceptable classification accuracy. Wearable sensors that assess HRV show promise as a tool for capturing risk of engaging in emotional eating episodes.

Poor executive function (EF; pre-frontal cognitive control processes governing goal-directed behavior) and elevated hedonic hunger (i.e., preoccupation with palatable foods in the absence of physiological hunger) are theoretical risk and maintenance factors for binge eating (BE) distinct from general obesity. Recent theoretical models posit that dysregulated behavior such as BE may result from a combination of elevated appetitive drive (e.g., hedonic hunger) and decreased EF (e.g., inhibitory control and delayed discounting). The present study sought to test this model in distinguishing BE from general obesity by examining the independent and interactive associations of EF and hedonic hunger with BE group status (i.e., odds of categorization in BE group versus non-BE group). Treatment-seeking overweight and obese women with BE (n = 31) and without BE (OW group; n = 43) were assessed on measures of hedonic hunger and EF (inhibitory control and delay discounting). Elevated hedonic hunger increased the likelihood of categorization in the BE group, regardless of EF. When hedonic hunger was low, poor EF increased the likelihood of categorization in the BE group. Results indicate that the interplay of increased appetitive drives and decreased cognitive function may distinguish BE from overweight/obesity. Future longitudinal investigations of the combinatory effect of hedonic hunger and EF in increasing risk for developing BE are warranted, and may inform future treatment development to target these factors.

The current study was designed to test potential caloric and macronutrient counter-regulation or compensation amongst 76 participants who participated in a milkshake preload experiment. Participants completed food diaries for 2 days before and 2 days after participating in the pre-load experiment. It was hypothesized that dieters and restrained eaters might respond to the pre-load by compensating or counter-regulating food consumption during the rest of the day following the experiment, and on the 2 days post-experiment. Results indicated that there were no significant differences in caloric or macronutrient consumption between the experimental and control groups on the days after the experiment. There were also no interactions between restraint and dieting status and the experimental condition. However, there was a main effect of caloric intake across dieting status, with those dieting to lose weight showing lower caloric intake than those not dieting and those dieting to maintain weight. The results of this study suggests that disinhibitory food stimuli may be less powerful than once thought or relatively short acting, as long-term counter-regulation or compensation did not occur for most people. Overall, the current study provides additional insight into potential long term caloric counter-regulation or compensation in participants who participated in a preload experiment, but additional research is needed to better understand this phenomenon.