Evaluation of extinction as a functional treatment for binge eating.

Four adult women who binged at least twice a week took part. Each woman wore a small recorder that captured her own harsh self-talk during urges.

When an urge hit, the therapist played the clip aloud. The women had to listen all the way through. No food, no escape, no comfort.

This blocked the usual emotional payoff that keeps binge eating alive. The team tracked binges across baseline, treatment, and follow-up.

Binge episodes dropped for every participant once the audio playback started. The behavior stayed low as long as the procedure was used.

When staff missed sessions, binges crept back up. The moment playback returned, the count fell again.

The study shows extinction can work for adult binge eating when the reinforcer is internal self-talk.

Scott et al. (2024) pooled 266 kids and found escape plus non-escape extinction best for feeding refusal. Amanda et al. used the same core tool—extinction—but aimed it at internal, not external, escape.

Najdowski et al. (2003) proved escape extinction is the active piece in pediatric feeding. The 2008 paper stretches that idea to automatically reinforced adult behavior.

McLaughlin et al. (1972) warned that extinction can drag down good behaviors along with bad. Amanda’s team saw no such spill-over, likely because the audio cue was tightly timed to the binge urge.

If you work with adults who binge, try adding a brief audio replay of their own urge talk. No extra staff, no food logs—just a phone and headphones. Start in session, then send the clip home. Track binges daily and keep the playback contingent on the urge. Drop it only after a clear downward trend holds for two weeks.