Text below adapted from The patient who has an eating disorder, Psychiatry in primary care, by David S. Goldbloom, (CAMH, 2019).
Bulimia Nervosa and Binge Eating Disorder
Cognitive-behavioural therapy (CBT) and interpersonal therapy (IPT) are the most validated treatments for bulimia nervosa and binge eating disorder. Many primary care practitioners—and some psychiatrists—may feel insufficiently skilled in these modalities, but training in these approaches is becoming more popular as continuing education.
CBT is particularly appealing because it takes a common-sense, here-and now approach, requires patients to do homework and challenge their own assumptions, and focuses on behavioural change. It is a skill set that can also be effective in primary care for managing depression, anxiety, irritable bowel syndrome and insomnia. Alternatively, community-based social workers, psychologists, occupational therapists and counsellors with this skill could be enlisted to the treatment team.
The evidence base for psychotherapy—or other treatments—is much weaker than for bulimia nervosa and binge eating disorder. However, there is a role for family therapy after weight restoration in adolescents.
In Eating Disorders: