Cue exposure in the treatment of resistant bulimia nervosa

Objective It was hypothesized that binge eating (bulimia nervosa [BN]) may be caused by the anticipatory and immediate anxiety associated with certain types of food. Consequently, an extinction schedule should reduce binge eating. Methods Cue exposure was carried out with 6 bulimic women who had responded poorly or not at all to the usual pharmacologic or cognitive‐behavioral treatments. Results Binge eating and vomiting were almost totally suppressed in the 6 patients. Symptom suppression was maintained at two follow‐ups, one at 4–20 months and another at 2.5–3 years. Discussion Cue exposure may be effective with BN that is resistant to conventional treatments. The anxiety associated with food plays an important role in provoking and/or maintaining binge eating. Motivation to change is likely to be an important mediator. © 2003 by Wiley Periodicals, Inc. Int J Eat Disord 34: 227–234, 2003.