Abstention during cue reactivity assessment is associated with better outcome among women with bulimia nervosa

To compare women with bulimia nervosa who abstained from eating during pretreatment cue reactivity assessment with those who ate.

135 participants in a randomized clinical trial completed an assessment of cue reactivity to individualized high-risk binge foods prior to treatment. A broad range of physiological, self-report, and behavioral measures of cue reactivity was assessed. Primary, secondary, and tertiary outcome measures of eating disorder symptomatology were evaluated at pretreatment, midtreatment, posttreatment, and 6-month follow-up.

As expected, women who abstained from eating during pretreatment cue reactivity assessment exhibited less cue reactivity than women who ate. This was especially evident for self-report measures of cue reactivity. Surprisingly, women who abstained from eating during pretreatment cue reactivity assessment also had significantly less eating disorder symptomatology at 6-month follow-up.

Possible psychological mechanisms contributing to the superior outcome of women who abstained from eating during the cue reactivity assessment and implications for the assessment of cue reactivity are discussed.