Efficacy of Tube Feeding in Binge-Eating/Vomiting Patients: A 2-Month Randomized Trial With 1-Year Follow-Up

Background: In many binge-eating/vomiting patients, abstinence could not be obtained from classical treatments. Since the authors showed that tube feeding (TF) reduced such episodes in anorexia nervosa (AN)-hospitalized patients, they carried out a randomized trial on the efficacy of TF plus cognitive behavioral therapy (CBT) vs CBT alone in AN and bulimia nervosa adult outpatients. Methods: The authors randomly assigned 103 ambulatory patients to receive 16 sessions of CBT alone (n = 51) or CBT plus 2 months of TF (n = 52). The main goal was abstinence of binge-eating/vomiting episodes. Other criteria were gains in fat-free mass and muscle mass improvements in nutrition markers, and quality of life (SF-36 Health Survey), depression (Beck Depression Inventory), and anxiety (Hamilton Anxiety Rating Scale) scores. Evaluations were performed at 1, 2 (end of treatment), 5, 8, and 14 months (analysis of variance). Results: TF patients were rapidly and more frequently abstinent at the end of treatment (2 months) than the CBT patients: 81% vs 29% (P <.001). Fat-free mass, biological markers, depressive state (-58% vs -26%), anxiety (-48% vs -15%), and quality of life (+42% vs +13%) were more improved in the TF group than in the CBT group (P <.05). One year later, more TF patients remained abstinent (68% vs 27%, P =.02); they were less anxious, were less depressed, and had better quality of life than the CBT patients (P <.05). Conclusion: TF combined with CBT offered better results than CBT alone. (JPEN J Parenter Enteral Nutr. 2011; 35: 356-364)