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A specific form of talk therapy may help people with binge-type eating disorders stop their unhealthy behaviours with just a few months of treatment, research suggests.
A multi-study review of psychological therapies for bulimia nervosa showed that bulimia-specific talk therapy, also called cognitive behaviour therapy (CBT), compared with no treatment, led to cessation of binge eating in about 37% of those treated, Dr Phillipa Hay, at the University of Western Sydney in Australia, and colleagues found.
In contrast, among bulimics on a wait-list for treatment and, therefore, not receiving any therapy, only 3% stopped binging and purging behaviours, they report in the Cochrane Database of Systematic Reviews, a publication of the Cochrane Collaboration, an international organisation that evaluates medical research.
Bulimia-specific CBT targets overeating and subsequent self-induced vomiting or heavy laxative use that purges food from the body after binge eating episodes. Therapy focuses on dietary habits, fear of weight gain, and how to "normalise" thoughts about food and body image.
Bulimia-specific CBT "takes around four to five months," Hay noted in an email to Reuters Health, adding that other psychotherapies take longer – about a year – to reach similar levels of efficacy.
Bulimia-specific CBT: treatment of choice
For their research, Hay and colleagues reviewed 48 studies that assessed different psychotherapies for bulimia nervosa and binge eating, including interpersonal, psychoanalytic, hypnosis, following procedures of a self-help book, and bulimia-specific CBT.
The studies involved 3,054 adults living in the United States, Canada and the United Kingdom who generally had weekly sessions for an average of about 16 weeks.
Follow-up assessments occurred within 10 months after therapy ended.
When analysed as a whole, the findings suggest bulimia-specific CBT may be the treatment of choice for this eating disorder, the investigators conclude. CBT may also significantly improve related symptoms such as depression, Hay noted.
However, "adding other psychotherapies to CBT likely can improve outcomes for people with other problems in their lives (like relationship problems)," Hay said.
(Reuters Health, October 2009)
