Bulimia Treatment: Success in Research and Treatment

Bulimia treatment research continues to demonstrate promising results in several contemporary studies using cognitive-behavioral and interpersonal psychotherapy. Bulimia treatment models utilizing cognitive-behavioral therapy usually seek to teach individuals how to change abnormal thoughts and behavior, and usually reward or model appropriate behavior. Patients are usually encouraged to change distorted and rigid thinking patterns according to the cognitive-behavioral bulimia treatment model. Group therapy continues to be another successful tool in the arsenal of the therapist providing bulimia treatment, along with interpersonal therapy, family therapy and short-term medication therapy with Prozac.

Some of the most interesting and effective bulimia treatment research has looked at and compared the effectiveness of several different forms of psychotherapy. A study reported in the May 2000 issue of the Archives of General Psychiatry (Vol. 57, No. 5) randomly assigned 220 patients with bulimia nervosa to one of two types of psychotherapy. One of the forms of bulimia treatment included cognitive-behavioral therapy designed to address bulimic symptoms, while the other was interpersonal psychotherapy, which helps individuals to alleviate relationship issues. The cognitive-behavioral bulimia treatment helped individuals to work with their unrealistically negative thoughts about their appearance and guided them in changing their behaviors by, for instance, helping them to normalized their diet. The interpersonal psychotherapy bulimia treatment focused on problems which occurred in important relationships , helping patients to address conflicts with family members and significant others, and improving the quality of those relationships, while at the same time, helping them to expand their social network.

The studies authors, Agras of Stanford, Walsh of Columbia University, Fairburn of Oxford University and Kraemer of Stanford, found both forms psychotherapy to be effective. The results confirmed Fairburn’s earlier findings which demonstrated that immediately after treatment, a significant number of cognitive behavioral therapy patients had stopped binging and purging and demonstrated positive changes in psychosocial eating disorder symptoms such as preoccupation with shape and weight, depression and issues related to self-esteem. The findings also reinforced some of Fairburn’s original findings that interpersonal psychotherapy patients did worse than cognitive behavioral therapy patients at the beginning, but also had similar improvements at a one year follow-up. The findings continued to reinforce that cognitive behavioral therapy is an effective bulimia treatment, but that interpersonal psychotherapy might be also.

The studies’ authors concluded that these findings may suggest the need for tailored treatment for women whom do not respond well to bulimia treatment. They concluded that patients who benefited from cognitive-behavioral therapy tended to do so in six to eight sessions, and that if you do not see an early response to cognitive behavioral therapy, you may need to think about changing treatment strategies to an interpersonal model.

Walsh and his colleagues reported in the August 2000, American Journal of Psychiatry (Vol. 157, No. 8), on their study of individuals who did not respond to cognitive-behavioral therapy or intrapersonal psychotherapy, which were then randomly assigned to either a Prozac or placebo control group. Those who took Prozac showed a much greater level of symptom reduction then those given the placebo. The authors concluded that these findings strongly suggested that antidepressant medications can be very helpful for someone who doesn’t succeed with one or the other of these treatments. However, at the present time, Prozac seems to be the only SSRI with demonstrated treatment efficacy based upon contemporary research.

Information and webpage by Paul Susic MA Licensed Psychologist Ph.D Candidate (Health Psychology 

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