Cognitive-Behavioural Therapy for Bulimia Nervosa in the “Real World”: What's the Evidence?

Cognitive-behavioural therapy (CBT) is commonly described as the evidence-based treatment for bulimia nervosa. But do the findings from nearly perfectly crafted trials, with stringently followed protocols and “ideal” participants apply to the “real world”? How generalizable are the findings from carefully selected participants to clinical populations where, for one, the prevalence of psychiatric comorbidities is relatively high?

In other words, CBT has been shown to be efficacious (i.e., it works in a controlled experimental research trial setting) but is it effective (i.e., does it work in a clinical setting where clients might have multiple diagnoses and complex needs)?

This is precisely the question that Glenn Waller and colleagues sought to answer. They wanted to see whether CBT would work in a “routine clinical setting, where none of the exclusion-and protocol-based constraints […] apply.”

PARTICIPANTS

Participants were recruited from a publicly-funded outpatient ED service in the UK. The only exclusion criteria … Continue reading →

What’s it Like to be a Man with an Eating Disorder?

What is it like for men to live with an eating disorder? What is it like for men to seek and receive treatment for an eating disorder? These are the questions that Kate Robinson and colleagues asked a group of eight men who were receiving treatment (inpatient, day patient or outpatient) at two ED treatment centers in the UK. Their goal was to find out if and how men’s experiences with an eating disorder differ from women with eating disorders.

Men account for roughly 10% of eating disorder patients (when considering anorexia and bulimia, not including binge eating disorder, which is not yet part of the DSM). I suspect this number is actually higher – as less men probably realize they have an ED, admit to having an ED or seek treatment, precisely due to the issues raised in this article (and others). Given that men form a sizeable … Continue reading →