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Binge Eating Disorder — MRCPsych Paper B MCQ

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ModerateEating DisordersBinge Eating DisorderMRCPsych Paper B

A 28-year-old woman with binge-eating disorder has a BMI of 38 kg/m² and reports four binge-eating episodes each week without compensatory behaviours. She has not previously received psychological treatment and has no contraindication or stated preference against guided self-help. According to NICE NG69, which intervention should be offered initially to treat her binge-eating disorder?

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Correct answer: B — Binge-eating-disorder-focused guided self-help

The correct answer is B. NICE recommends binge-eating-disorder-focused guided self-help as the initial psychological treatment for adults with binge-eating disorder. It uses cognitive behavioural self-help materials with brief practitioner support. Her elevated BMI does not alter this first-line treatment: reducing body weight is not the immediate target of eating-disorder therapy, although obesity can be addressed separately. If guided self-help is unacceptable, contraindicated or ineffective after 4 weeks, group CBT-ED should be offered. Individual CBT-ED is considered if group treatment is unavailable or declined, so A is not the initial step. Family therapy is not the recommended first-line intervention for an adult with binge-eating disorder. Medication should not be used as sole treatment, and bariatric surgery treats obesity rather than the binge-eating disorder itself.

Reference: National Institute for Health and Care Excellence. Eating disorders: recognition and treatment (NG69), section 1.4, recommendations 1.4.1–1.4.9. Published 2017; updated 2020; reviewed 2024. https://www.nice.org.uk/guidance/NG69/chapter/recommendations