title: Cognitive-behavioral therapy for bulimia nervosa and atypical bulimic nervosa: effectiveness in clinical settings.
abstract: OBJECTIVE
  The efficacy of cognitive-behavioral therapy (CBT) for bulimic disorders has been established in research trials. This study examined whether that efficacy can be translated into effectiveness in routine clinical practice.
  
  
  METHODS
  Seventy-eight adult women with bulimic disorders (bulimia nervosa and atypical bulimia nervosa) undertook individual CBT, with few exclusion criteria and a treatment protocol based on evidence-based approaches, utilizing individualized formulations. Patients completed measures of eating behaviors, eating attitudes, and depression pre- and post-treatment. Eight patients dropped out. The mean number of sessions attended was 19.2.
  
  
  RESULTS
  No pretreatment features predicted drop-out. Treatment outcome was similar whether using treatment completer or intent to treat analyses. Approximately 50% of patients were in remission by the end of treatment. There were significant improvements in mood, eating attitudes, and eating behaviors. Reductions in bingeing and vomiting were comparable to efficacy trials.
  
  
  CONCLUSIONS
  The improvements in this "real-world" trial of CBT for adults with bulimic disorders mirrored those from large, funded research trials, though the conclusions that can be reached are inevitably limited by the nature of the trial (e.g., lack of control group and therapy validation).
authors.affiliation: Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, Sheffield, England, United Kingdom.
authors.forename: Glenn
authors.initials: G
authors.lastname: Waller
authors.forename: Emma
authors.initials: E
authors.lastname: Gray
authors.forename: Hendrik
authors.initials: H
authors.lastname: Hinrichsen
authors.forename: Victoria
authors.initials: V
authors.lastname: Mountford
authors.forename: Rachel
authors.initials: R
authors.lastname: Lawson
authors.forename: Eloise
authors.initials: E
authors.lastname: Patient
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D001294:Attitude to Health; D015992:Body Mass Index; D052018:Bulimia Nervosa / Q000145:classification / Q000523:psychology* / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D006801:Humans; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D011594:Psychometrics; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors
keywords: atypical bulimic disorders; bulimia nervosa; cognitive-behavioral therapy; effectiveness