Cognitive behavioral therapy more effective than antidepressant medications for bulimia nervosa

Evidence Report, Resources, Tools, and Tips Available for Free on Patient-Focused Website

A new evidence report by ECRI Institute comparing the effectiveness of various treatments for bulimia nervosa indicates that cognitive behavioral therapy is more effective than antidepressant medications and supportive therapies in improving eating disorder symptoms. ECRI Institute, an independent nonprofit organization that researches the best approaches to improving patient care, published the comprehensive report and other updated resources at www.bulimiaguide.org for free access by patients, healthcare professionals, and concerned families and friends. The Bulimia Nervosa Resource Guide website provides in-depth information about the disorder, risk factors, diagnosis, treatment options and costs, tips for family and friends on how to be supportive to the patient, and much more.

This is ECRI Institute's second comprehensive, systematic review of treatments for bulimia nervosa. The first, published in 2006, established that antidepressant medications and psychological therapies were better than no treatment. The current report considered how well the most commonly offered treatments work by comparing medications (e.g., antidepressants), various psychological therapies such as cognitive behavioral therapy, and combinations of those therapies. The authors also considered how certain types of treatments are delivered, such as self-help versus therapist-led therapy.  

"This expanded assessment delves deeper into establishing which of the available treatments is most effective," says Stacey Uhl, M.S.S., Senior Research Analyst, ECRI Institute.

A few key findings from the current systematic review indicate that:

• Cognitive behavioral therapy is more effective than antidepressant medications in reducing the average number of binge eating episodes for some individuals.  
• Patients who receive cognitive behavioral therapy are more likely to go into remission from purging and demonstrate improvements in associated eating disorder pathology than patients treated with supportive therapies. (Supportive therapies focus on management and resolution of personal difficulties and life decisions using the patient's strengths.)
• Cognitive behavioral therapy is more effective than behavioral therapy in reducing the average number of purging episodes for some individuals.

The complete evidence report, Bulimia Nervosa: Comparative Efficacy of Available Psychological and Pharmacological Treatments, technical and non-technical summaries of the report, and other patient-focused resources are available for free at www.bulimiaguide.org.

With more than 1.8 million visits since its launch in 2006, the Bulimia Nervosa Resource Guide provides a comprehensive, evidence-based resource for all those affected by bulimia nervosa—a complex mental health disorder with serious medical consequences for the patient and a significant impact on the families and friends of these patients. The free site also includes a searchable directory of residential facilities that treat bulimia nervosa, a list of ongoing clinical trials, a review of state mental health parity laws and mandates, a catalog of current health insurance coverage policies for bulimia nervosa, and links to other relevant resources.

"From the outset, the research for the Bulimia Nervosa Resource Center, including the comparative effectiveness review of clinical studies, was guided by families and patients with concerns about bulimia nervosa," says Jeffrey C. Lerner, Ph.D., President and CEO, ECRI Institute. "The intent was to equip patients and consumers with objective, science-based information and tools to inform their decisions and provide guidance for the recovery process."

The Bulimia Nervosa Resource Guide is part of ECRI Institute's plan for a National Patient Library™ of evidence-based patient information. ECRI Institute updated the evidence report under a grant from the Hilda and Preston Davis Foundation.