The interruption of bulimic behaviors. A review of three treatment programs

Three programs for treating bulimic behaviors have been reviewed. Before these treatment regimens are recommended for general use, controlled outcome research must confirm that positive resuts, noted immediately after treatment, continue at follow-up. These treatments have an outpatient approach in common, a heavy reliance on behavioral treatments including cognitive restructuring, emphasis on individual patient responsibility for progress in treatment and an expectation for success by supportive therapists and by patients. Although the structure of these three programs is quite different, they are all designed to interrupt or reduce bulimic behavior and provide a period of stabilization that will permit the patient to avoid relapse following treatment. All of the reviewed programs emphasize patient education, behavioral self-monitoring, and healthy eating behaviors. Patient education focuses on bulimia and its treatment and on nutrition and adaptive eating patterns. Behavioral self-monitoring of intake of food, bulimic behaviors, associated thoughts and feelings, reasons for electing to binge eat is required of the participants. This is designed to enhance patient awareness so that a shift to healthy eating habits can occur. Weight maintenance, changing attitudes about food, and the consumption of three healthful meals a day are stressed as a further part of these highly structured systems. The availability of adequate treatment for the illness of bulimia is of importance to psychiatrists and mental health professionals. The techniques described in this article provide guidelines for the development of such treatment programs.