Neural Response to Food Stimuli: fMRI Changes Following Cognitive Behavioral Therapy for Binge Eating Disorder

Females with a BMI>/=25 kg/m2 and BED will be randomized to either a 16-week, one-on-one CBT intervention (n=20) or a waitlist control (WL; n=20). Both groups will have blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) scans at baseline and after the 16-week intervention. During the scans, participants will complete the following tasks: 1) food-specific stop signal task (SST), and 2) script-driven imagery of binge foods.

Inclusion criteria

• Women who meet the DSM-5 criteria for BED as diagnosed by the Eating Disorder Examination Interview
• Ages 18 to 45 years of age
• BMI >/=25 kg/m2
• Premenopausal
• Able to provide informed consent
• Right-handed
• Eligible female patients will be:

• Non-pregnant, evidenced by a negative urine dipstick pregnancy test
• Non-lactating
• Surgically sterile or postmenopausal, or they will agree to continue to use an accepted method of birth control during the study
• Understand and be willing to comply with all study-related procedures and agree to participate in the study by giving written informed consent

Exclusion criteria

• Weight > 158.8 kg (350 lbs, due to scanner weight restrictions)
• Supine abdominal width (with arms folded above) > 70 cm or sagittal diameter > 50 cm (due to scanner dimension restrictions)
• Pregnant or nursing (or plans to become pregnant in the next 5 months)
• Evidence of psychiatric disorder that significantly interferes with daily living
• Active suicidal ideation
• Type 1 diabetes or type 2 diabetes or A1C > 6.5%
• Use of weight loss medications or other agents known to affect body weight (e.g., oral glucocorticoids, second-generation antipsychotic medications) in the past 3 months
• Psychiatric hospitalization within the past 6 months
• Self-reported alcohol or substance abuse within the past 12 months, including at-risk drinking (current consumption of ≥ 14 alcoholic drinks per week)
• Self-reported use of illicit drugs within the past 30 days
• Presence or history of orthopedic circumstances, metallic inserts, pacemaker, claustrophobia, or other conditions that may interfere with magnetic resonance imaging
• Loss of ≥ 10 lb of body weight within the past 3 months
• History of (or plans for) bariatric surgery
• Visual, auditory, or other impairment that would affect task performance
• Epilepsy or other brain injury
• Participation in individual psychotherapy for BED in the prior 3 months
• Inability to attend treatment and lack of capacity to provide informed consent
• Any serious or unstable medical or psychological condition that, in the opinion of the investigator, would compromise the patient's safety or successful participation in the study