A Comparison of Nutritional Management with Stress Management in the Treatment of Bulimia Nervosa

Laessle, Reinhold G.; Beumont, P. J. V.; Butow, Phyllis; Lennerts, W.; O'Connor, Maureen; Pirke, Karl M.; Touyz, Stephen; Waadt, Sabine

doi:10.1192/bjp.159.2.250

Cited by 81 publications

(48 citation statements)

References 30 publications

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“…A trend emerged among studies' reports of treatment efficacy: treatment outcome studies tended to favor treatment interventions as predicting positive outcome (23,24,28,33,39,61,62), while naturalistic studies found previous treatment interventions to be unassociated with outcome (4,8,9,17,59). Two exceptions to this pattern exist.…”

Section: Treatmentmentioning

confidence: 87%

Outcome in bulimia nervosa

1997

AJP

305

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A lthough binge eating and purging were observed in women with anorexia nervosa, bulimia nervosa is a relatively recent addition to the medical literature, having been first described in 1979 (1). Consistent with the negative impact that binge eating and purging were observed to have on anorectic patients' outcome (2), bulimia nervosa was termed "an ominous variant of anorexia nervosa." This dire description was tempered with the recognition that "only a brief comment on the prognosis of bulimia nervosa is appropriate, for long-term follow-up studies have not been undertaken" (1). Now, more than 15 years later, little additional information seems available. A single study of 44 women diagnosed with bulimia nervosa 10 years earlier (3) provides the only available data on long-term outcome. Indeed, DSM-IV states, "The long-term outcome of Bulimia Nervosa is not known."Comparing and summarizing results across those outcome studies which do exist are complicated by methodological differences among and within studies. For example, one study (4) employed four different measures of eating disorder outcome in order to attribute differences in recovery estimates to the impact of assessment methods. That study found that the range of those considered recovered was 29% to 42%. Thus, inconsistent findings across studies may be partially attributed to differences in methods of assessment, as well as sample characteristics, definitions of terms, and ascertainment rates.The limited availability and comparability of research findings leave the following questions largely unanswered: What is the long-term physical, psychological, and psychosocial outcome among women diagnosed with bulimia nervosa? What percentage of women re-

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Section: Treatmentmentioning

confidence: 87%

Outcome in bulimia nervosa

1997

AJP

305

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“…Com os unitermos utilizados, apenas seis artigos publicados no Brasil foram encontrados 25,26,[36][37][38] , sendo apenas dois com foco no tratamento nutricional da BN 25,26 . Na literatura internacional, a busca com esses unitermos resulta em estudos sobre o papel de neurotransmissores e peptídeos [39][40][41] , tratamentos combinados [42][43][44][45][46] , e alguns com foco específico no tratamento nutricional [47][48][49] .…”

Section: Perspectivas De Continuidade Das Pesquisas Na áReaunclassified

“…Esses trabalhos apontam que o tratamento nutricional deve ser visto como uma primeira intervenção necessária 42 , para todos os pacientes; que a intervenção nutricional é efetiva para BN -com melhoras mantidas em três meses de segui-mento- 44 e que a TCC combinada à terapia nutricional permanece como tratamento de escolha para BN 45 .…”

Section: Perspectivas De Continuidade Das Pesquisas Na áReaunclassified

“…Muitas vezes, de fato, os estudos analisam o efeito do tratamento nutricional isolado (como estratégia única de tratamento) versus a TCC 38,[42][43][44][45][46] , mas se acredita que o ideal seria analisar a TCC versus TCC mais tratamento nutricional, uma vez que o tratamento nutricional não deve ser nunca uma estratégia única de tratamento, dada a necessidade de uma equipe e de uma abordagem multiprofissional 31 .…”

Section: Perspectivas De Continuidade Das Pesquisas Na áReaunclassified

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Tratamento nutricional da bulimia nervosa

Alvarenga

Scagliusi

2010

Rev. Nutr.

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Rev. Nutr., Campinas, 23 (5) R E S U M OA bulimia nervosa é um transtorno alimentar caracterizado por compulsões alimentares e métodos compensatórios recorrentes. Os pacientes apresentam ingestão alimentar inadequada e comportamentos alimentares disfuncionais. O adequado tratamento do transtorno requer uma equipe multiprofissional e terapia nutricional especializada. Compreender as características desse transtorno, os padrões de consumo e o comportamento alimentar, bem como atentar para as atitudes alimentares dos pacientes, é fundamental para o planejamento e para a adequada condução da abordagem nutricional. A terapia nutricional para esse transtorno é diferenciada, exigindo do nutricionista maiores habilidades de aconselhamento nutricional. Educação nutricional e aconselhamento nutricional, com ênfase na abordagem de atitudes alimentares e insatisfação corporal, são o foco da terapia nutricional. Para o atendimento eficaz desses pacientes e o sucesso no tratamento nutricional, é importante que o profissional se mantenha atualizado sobre nutrição e transtornos alimentares e procure especialização e experiência nessa área do conhecimento. Termos de indexação:Aconselhamento. Bulimia nervosa. Hábitos alimentares. Terapia nutricional. A B S T R A C T

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“…For example, Laessle et al (1991) compared what they called a nutritional management (NM) treatment with stress management. The former closely approximated the behavioral components (Stage 1) of manual-based CBT (Fairburn et al, 1993).…”

Section: A Rose By Any Other Namementioning

confidence: 99%

Cognitive-behavioral therapy and nutritional counseling in the treatment of bulimia nervosa and binge eating

Latner

Wilson

2000

Eating Behaviors

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The goals of manual-based cognitive-behavioral therapy (CBT) and nutritional counseling for eating disorders are similar, namely, eliminating dysfunctional patterns of eating. Modifying these behaviors requires specific therapeutic expertise in the principles and procedures of behavior change that is not typically part of the training of nutritionists and dieticians or mental health professionals without specific expertise. We discuss ways in which principles of behavior change can be applied to eating disorders by non-CBT experts. Specific nutritional rehabilitation programs have the potential to augment CBT in addressing the array of appetitive abnormalities present in eating disorder patients. The dysfunctional appetitive, hedonic, and metabolic characteristics of patients with bulimia nervosa (BN) and binge eating disorder are reviewed. These abnormalities constitute potential target areas that might be more fully addressed by nutritional interventions designed to restore normal appetitive function. D

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A Comparison of Nutritional Management with Stress Management in the Treatment of Bulimia Nervosa

Cited by 81 publications

References 30 publications

Outcome in bulimia nervosa

Outcome in bulimia nervosa

Tratamento nutricional da bulimia nervosa

Cognitive-behavioral therapy and nutritional counseling in the treatment of bulimia nervosa and binge eating

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