Combining Cognitive Training and Brain Stimulation: A Novel Approach to Address Disordered Eating and Antipsychotic-Induced Weight Gain in People With Severe Mental Illness.

In 30 seconds

This double-blind, parallel-group, sham-controlled randomised trial assessed the feasibility of combining Approach Bias Modification Training (ABMT) with real or sham transcranial direct current stimulation (tDCS) in adults with schizophrenia or schizoaffective disorder taking stable antipsychotic doses. Twenty-eight participants were recruited and received five sessions over 3 weeks. Retention was 85.7% after treatment and 78.6% at 2-week follow-up. Medium effect sizes favoured real tDCS for reducing binge eating (d = -0.6, 95% CI -1.5, 0.3), but the study was not a confirmatory effectiveness trial.

Key findings

• Twenty-eight participants were recruited (93% of target); retention was 85.7% post-treatment and 78.6% at 2-week follow-up.
• The effect size for binge-eating reduction favoured ABMT plus real tDCS (d = -0.6, 95% CI -1.5, 0.3).
• Only the real-tDCS arm showed within-group reductions in food approach biases and binge-eating episodes (all p < 0.05).
• Frequent binge-eating episodes were reported by 43% in the real-tDCS arm and 28.6% in the sham-tDCS arm.

Why it matters

Binge eating and weight gain during antipsychotic treatment can contribute to cardiometabolic risk. This feasibility trial suggests that a brief combination of cognitive training and brain stimulation can be delivered and may influence eating-related outcomes in people with severe mental illness. The findings support further investigation, while the small trial and uncertain effect estimates do not establish clinical effectiveness.

What to keep in mind

The trial recruited only 28 participants and followed them for 2 weeks after treatment; effect estimates were imprecise, and the study was designed to assess feasibility rather than confirm effectiveness.