Treatments of Bulimia Nervosa Research Paper

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[. . .] Results showed on significant benefit from the combined treatment on depression symptoms. A significant advantage was computed for impairment in the short-term of 12 weeks only. The combination, therefore, was found to produce limited advantage due to the varied sampling and methodology. Future research should focus on predictors of response and clinical components (Dubicka et al.). This is level-1 evidence, which can be generalized.

8. A single-site study, conducted by Riggs and her team (2007) aimed at comparing the effect of fluoxetine hydrochride against that of placebo in treating depression and related disorders in adolescents. They performed a randomized controlled trial from May 2001 to August 2004 on 126 adolescent volunteers, aged 13-19, from the community and according to the requirements of DSMMD for 16 weeks. Measures used were the Childhood Depression Rating Scale-Revised and Clinical Global Impression Improvement and self-reported symptoms for the past 30 days. The results showed that fluoxetine with CBT appeared to be similarly safe and effective for depression in participants with substance use disorder and those depressed but not into substance use. The researchers surmised that CBT may have produced the higher-then-expected response and thus blur the efficacy result (Riggs et al.). This is level-2 evidence, which can be generalized.

9. Hall (2008) and her team conducted multiple consistent RCTs to determine the most effective treatment or treatments for BN in adolescents. The group used a Cochrane review of 40 RCTs of 1-220 patients at a mean of 60 for 16 weeks median and a follow up median of 7.5 months. At that time of the test, CBT was considered the most effective. It confirmed that, compared with no treatment, CBT substantially improved symptoms. CBT also proved more significantly efficacious than other forms of psychotherapy in inducing eating abstinence. Guided self-help alone did not reduce binge and purge episodes. Results of this test and other case-control studies provided evidence that pharmacotherapy with anti-depressants are effective in treating BN. The combination is even more effective when psychotherapy is added. Remission rates were low but long-term follow-up data were limited (Hall et al.).

10. Schmidt (2007) and his associates conducted a randomized control trial of family therapy and CBT guided self-care for participating adolescents diagnosed with Bulimia Nervosa and related disorders. Their objective was to compare the effectiveness and cost-effectiveness of these two types on 85 respondents from the United Kingdom. Of the total, 41 were assigned at random to the family therapy group and 44 to CBT guided self-care. The primary measures used were abstinence from binge eating and vomiting for 6 months and then at 12 through interviews. The secondary measures included the symptoms and costs of care. The primary hypothesis was that family therapy would induce higher rates of abstinence and induced vomiting at treatment and follow-up. The secondary hypothesis was that guided self-care would be more inexpensive than family therapy. Results showed that CBT-guided self-care had a slight advantage over family therapy. It induced faster reduction of bingeing, cost less and was more acceptable to adolescents with BN (Schmidt et al.). This is level-2 evidence and can be generalized.


Of the 10 RTCs, 7 confirm the effectiveness of CBT in treating the symptoms of Bulimia Nervosa in combination with SSRIs. The combination is superior but only in the short-term (Boodyet et al., 2007). It accelerates improvement with SSRIs as well as raises the safety level (The TADS Team, 2007). The combination is better than simply switching SSRIs without the combination (Brent et al., 2008). Walkup (2008) and his team agree. Hay (2008) and his team also say that CBT alone will work on BN. Riggs (2007) and team that the combination will work. And Schmidt (2007) say the combination is more effective than family therapy. Of the 7 who confirm the benefits of CBT, 5 agree that the combination of CBT and SSRIs is the best treatment for BN.


CBT has been described as a talking therapy, which endeavors to solve emotional or behavioral problems and behaviors through a systematic approach (Osterhout, 2012). It appears best to manage BN through an interdisciplinary approach. This will involve and include a primary care provider, a psychiatrist, a psychotherapist, and a dietitian. It is preferable for the psychiatrist or psychotherapist to possess expertise in managing eating disorders. The dietitian should review and oversee the patient's nutritional rehab. A dentist and other health experts may also be needed. The overall aims should be to reduce or eliminate binge eating and purging, treat the complications, prevent them and enhance her overall health.


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Treatments of Bulimia Nervosa.  (2012, March 6).  Retrieved January 20, 2020, from

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