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Journal of Eating Disorders

Open Access

The sequential binge: a new therapeutic approach for binge eating

  • Remi Neveu1,
  • Guillaume Barbalat2Email author,
  • Dorine Neveu3,
  • Giorgio Coricelli4,
  • Ulrike Schmidt5 and
  • Alain Nicolas6
Journal of Eating Disorders20153(Suppl 1):O57

Published: 23 November 2015


Food IngestionHealth PromotionCognitive Behavioral TherapySignificant ProportionEating Disorder


A significant proportion of eating disorder patients experiencing binge eating do not respond to cognitive behavioral therapies (CBT). Here, we present a new behavioral technique, the sequential binge (SB) that aims at reducing both food intake during binges and daily binge numbers. Specifically, SB replaces the usual pattern of food ingestion during a binge by a repeated monotonous food ingestion sequence interspersed with short incremental pauses. This pattern of ingestion is hypothesised to facilitate boredom towards the ingested foods and promote a sense of control over binge foods.


15 eating disorder in-patients with refractory binge eating who were non-responsive to intensive CBT were given SB as an adjunct to their treatment. Patients were followed up for 16 weeks after SB implementation.


Compared to regular binges, SB was associated with a 44% relative reduction in the planned food intake during binges (p<0.001), a longer refractory period after the binge (median: 48hrs vs. 4hrs, p=0.002), and an average relative reduction of binges by 26% the day after SB (p=0.004).


This case series shows promising evidence for the use of SB in patients with refractory binge eating. Further evaluation of the use of SB for refractory binge eating in a prospective double-blind clinical study seems justified.

Authors’ Affiliations

Université de Lyon, Neuroscience Research Center, Lyon, France
Regional Eating Disorders Service, Greenlane Clinical Centre, Auckland, New Zealand
Université Montpellier, Montpellier, France
Interdepartmental Centre for Mind/Brain Sciences (CIMeC), University of Trento, Trento, Italy
Section of Eating Disorders, Institute of Psychiatry, King's College, UK
Hôpital du Vinatier, Bron, France


© Neveu et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.