Objective: To develop and evaluate a simplified and condensed cognitive behavioral treatment for bulimia nervosa suitable for use in primary care. Method: Once developed, the treatment was tested on a consecutive series of 11 patients. Results: Six patients did well, 3 were nonresponders, and in the other 2 external events interfered with progress. Discussion: This form of treatment may benefit a significant proportion of those patients with bulimia nervosa who are seen in primary care. it can be administered by nonspecialist therapists. 0 1996 by fohn Wiley & Sons, inc.
Given the prevalence of bulimia nervosa and the relative lack of specialist treatment facilities, there is a need to develop forms of treatment that can be used in nonspecialist settings. Pharmacotherapy is an obvious choice, but the evidence to date suggests that drug effects are not well maintained (Walsh, Hadigan, Devlin, Gladis, & Roose, 1991; Walsh, 1995). Brief psychological treatments are an alternative, but none has been satisfactorily evaluated.
We believe that the logical approach to this problem is to simplify a treatment already known to be effective. Cognitive behavior therapy is the leading candidate because it has been extensively evaluated and the findings are consistent in supporting its use (Fairburn, Agras, & Wilson, 1992). Cognitive behavior therapy not only produces rapid change but the evidence suggests that its effects are well maintained in the medium and longer term (Fairburn et al., 1992(Fairburn et al., , 1995)).