Self-Help for Bulimia Nervosa: A Randomized Controlled Trial

Abstract

The findings suggest that a subgroup of patients with bulimia nervosa may benefit from unguided self-help as a first step in their treatment. Cognitive behavior self-help and nonspecific self-help had equivalent effects.

Bulimia nervosa treatment: A systematic review of randomized controlled trials

“…No significant change was seen in weight, although those in the self-help condition weighed significantly more at 1 year. In addition, Carter et al 54 found that both CBTbased and nonspecific self-help approaches led to significant decreases in objective binge episodes and purging; the waiting list did not. CBT-based self-help was associated with greater reductions in reducing intense exercise than nonspecific selfhelp or waiting list.…”

“…42 Poorer outcomes were associated with greater food restriction, higher depression, higher drive for thinness and bulimia scores on the EDI, and greater cue reactivity, 38 low selfesteem, 49 and precontemplation stage of change. 47 Higher EDI perfectionism scores, higher Dimensional Assessment of Personality Pathology (DAPP) compulsivity scores, higher DAPP intimacy problem scores, and lower cognitive behavior knowledge scores 54 were all associated with positive response to self-help. Finally, higher soothing receptivity and ability to tolerate aloneness were associated with more positive outcomes in guided imagery therapy.…”

Self‐efficacy as a robust predictor of outcome in guided self‐help treatment for broadly defined bulimia nervosa

“…[15][16][17] In the literature investigating SH treatment approaches to BN, poorer treatment outcome has been found to be associated with a history of AN, presence of a personality disorder, low compliance with the SH manual, and increased baseline levels of binge eating episodes, shape and weight concerns, and general psychopathology. 12,[18][19][20][21][22][23] In general, the search for predictors of outcome in BN has been exploratory, rather than being guided by theory. A theory of particular interest that can guide outcome research is the stages of change model, 24 where motivation for change is implicated as an important predictor of outcome across different psychopathologies, and includes stages relating to precontemplation, contemplation, preparation, action, and maintenance.…”

Guided self‐help versus cognitive‐behavioral group therapy in the treatment of bulimia nervosa

“…Another strategy for treating patients with BN has been the use of self-help approaches. Several interesting studies, including a few randomized trials, have appeared in the literature (Carter et al, 2003;Cooper, Coker, & Fleming, 1994Huon, 1985;Palmer, Birchall, McGrain, & Sullivan, 2002). A number of self-help books are available (Cooper, 1995;Fairburn, 1995;Schmidt & Treasure, 1993;Weiss, Katzman, & Wolchik, 1986).…”