title: A comparison of nutritional management with stress management in the treatment of bulimia nervosa.
abstract: In a comparison of nutritional management (NM) and stress management (SM) for treatment of bulimia nervosa, 55 female patients were randomly assigned to either treatment. Therapy consisted of 15 sessions in a group over three months, by the end of which, patients under both treatment conditions showed a significant reduction in the frequency of binge eating and vomiting and a significant improvement in various psychopathological features such as body dissatisfaction and depression. All improvements were maintained over 12-month follow-up NM produced a more rapid improvement in general eating behaviour, a faster reduction in binge frequency and a higher abstinence rate from binge eating. SM led to greater positive changes in certain psychopathological features such as feelings of ineffectiveness, interpersonal distrust and anxiety. NM should be regarded as a necessary first intervention in all bulimic patients. Further psychological therapy, such as SM, is indicated as well for some patients, depending on their specific psychological difficulties.
authors.affiliation: Division of Psychoneuroendocrinology, Max Planck Institute for Psychiatry, Munich.
authors.forename: R G
authors.initials: RG
authors.lastname: Laessle
authors.forename: P J
authors.initials: PJ
authors.lastname: Beumont
authors.forename: P
authors.initials: P
authors.lastname: Butow
authors.forename: W
authors.initials: W
authors.lastname: Lennerts
authors.forename: M
authors.initials: M
authors.lastname: O'Connor
authors.forename: K M
authors.initials: KM
authors.lastname: Pirke
authors.forename: S W
authors.initials: SW
authors.lastname: Touyz
authors.forename: S
authors.initials: S
authors.lastname: Waadt
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D001835:Body Weight; D002032:Bulimia / Q000178:diet therapy* / Q000523:psychology*; D003131:Combined Modality Therapy; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D052756:Nutritional Sciences / Q000193:education*; D012064:Relaxation Therapy; D013315:Stress, Psychological / Q000150:complications* / Q000523:psychology