October 8, 2009 / 8:17 PM / 10 years ago

A few months of talk therapy treats bulimia

NEW YORK (Reuters Health) - A specific form of talk therapy may help people with binge-type eating disorders stop their unhealthy behaviors 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 behavior therapy (CBT), compared with no treatment, led to cessation of binge eating in about 37 percent of those treated, Dr. Phillipa P. J. 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 percent stopped binging and purging behaviors, they report in the Cochrane Database of Systematic Reviews, a publication of the Cochrane Collaboration, an international organization 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 “normalize” thoughts about food and body image.

Bulimia-specific CBT “takes around 4 to 5 months,” Hay noted in an email to Reuters Health, adding that other psychotherapies take longer — about a year — to reach similar levels of efficacy.

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 analyzed 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.

SOURCE: Cochrane Database of Systematic Reviews, October 2009

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