Bulimia nervosa: Pharmacologic and psychologic approaches to treatment

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Abstract
The apparent increase in the prevalence of bulimia nervosa has led to the discovery and use of new and effective treatment approaches. Two approaches, cognitive-behavioural treatment and antidepressants, have now been well studied in controlled clinical trials and have been shown to be effective. A review of the literature shows that eight studies have demonstrated the efficacy of antidepressant drugs, and 13 some form of cognitive-behavioural treatment. Research on the processes by which each of the treatments work and the implications of such research for clinical practice are reviewed. The two different treatments may have incompatible effects on dietary restraint; thus the combination of pharmacotherapy and cognitive-behavioural treatment would not be expected to be superior to either treatment alone. The tentative conclusion is that the treatment of first choice for bulimia nervosa should be cognitive-behavioural therapy.

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