Treatment of bulimia nervosa
© 2006 Stephen Wonderlich, James E Mitchell, Martina de Zwaan and Howard Steiger. Objectives of review. To identify advances in the treatment of bulimia nervosa (BN). Summary of recent findings. The NICE systematic review provides the best appraisal of what has been learned from the research on the treatment of BN, and the accompanying NICE guideline provides impartial evidence-derived recommendations regarding patient management. It is clear that a specific form of cognitive-behavior therapy (CBT) is the leading treatment for BN although its effectiveness needs to be enhanced. Early behavior change in treatment is a potent and reliable predictor of outcome. Managing these patients in primary care is difficult and the results are modest. It appears that self-help is of limited value. Future directions. There is a need to develop more effective treatments for BN. Research on adolescents is required since it cannot be assumed that findings obtained with adults will apply to younger patients. There is also a need for ‘effectiveness’ research in which treatments are evaluated under conditions that approximate those existing in routine clinical practice.