Clinician Administered Treatment Resources

Psychotherapy

According to the American Psychological Associations, Division 12, Society of Clinical Psychology,¹cognitive-behavioral therapy is a well established treatment for Bulimia Nervosa.^2,3 Interpersonal therapy is probably effective for treating Bulimia Nervosa.⁴ 

There is less evidence regarding effective treatments for Anorexia Nervosa compared to Bulimia Nervosa. Nutritional rehabilitation, which involves helping the individual slowly gain weight, is very important. Hospital-based programs should be considered when an individual is less than 75% of their ideal body weight.⁶ Hospitalization and treatment alone, have limited success. Patients often relapse after leaving the hospital. Cognitive-behavioral interventions as an out-patient can be effective in preventing relapse. It is important to monitor physical state during treatment including the patient's weight, vital signs (blood pressure and pulse), ECG, and routine labs throughout treatment. It is often useful to include nutritional counseling in the treatment protocol. Patients aged 18 and under experiencing relatively recent onset Anorexia Nervosa may benefit from family therapy.⁷

Overcoming Eating Disorders: A Cognitive Behavioral Treatment for Bulimia Nervosa and Binge-Eating Disorder
W.S. Agras & R.F. Apple

Treatment Manual for Anorexia Nervosa: A Family-Based Approach
J. Lock, D. le Grange, W. S. Agras, C. Dare, & W. Agras

Pharmacotherapy

For Anorexia Nervosa, psychotropic medications should not be routinely used when someone is actively trying to gain weight. Also, they should not be used as the sole or primary treatment for anorexia nervosa. Medications such as antidepressants maybe helpful to prevent relapse among weight-restored patients or to treat associated features of anorexia nervosa, such as depression or obsessive-compulsive problems.⁶

For Bulimia Nervosa, antidepressant medications can reduce symptoms of binge eating and purging and may help prevent relapse among patients in remission. ⁶ More

TRICARE Pharmacy Information

Other Resources

Handbook of Treatment for Eating Disorders: Second Edition
D. M. Garner & P. E. Garfinkel

Eating Disorders and Obesity, Second Edition: A Comprehensive Handbook
C. G. Fairburn & K. D. Brownell

Handbook of Eating Disorders and Obesity
J. K. Thompson

Eating Disorder Information for Health Care Providers
U.S. Department of Health and Human Services

¹Chambless, D. L., Baker, M. J. Baucom, D. H., Beutler, L. E., Calhoun, K.S. Crits-Christoph, P., Daiuto, A. et al. (1998). Update on the Empirically Validated Therapies II.  The Clinical Psychologist, 51, 1, 3-16.

²Agras, W.S., Schneider, J.A., Arnow, B., Raeburn, S.D., & Telch, C.F. (1989). Cognitive-behavioral and response-prevention treatments for bulimia nervosa. Journal of Consulting and Clinical Psychology, 57, 215-221.

³Thackwray, D.E., Smith, M.C., Bodfish, J.W., & Meyers, A.W. (1993). A comparison of behavioral and cognitive-behavioral interventions for bulimia nervosa. Journal of Consulting and Clinical Psychology, 61, 639-645.

⁴Fairburn, C. G., Jones, R., Peveler, R. C., Hope, R. A., O.Conner, M. (1993). Psychotherapy and bulimia nervosa: Longer-term effects of interpersonal psychotherapy, behavior therapy, and cognitive behavior therapy. Archives of General Psychiatry, 50, 419-428.

⁵Lock, J., & Schapman, A. M. (in press). Bulimia Nervosa. In J.E. Fisher & W. O’Donohue (Eds.), Practice Guidelines for Evidence Based Psychotherapy. New York: Kluwer Academic.

⁶American Psychiatric Association (2006). Practice Guideline for the Treatment of Patients With Eating Disorders, Second Edition. Accessed 5/30/06.

⁷Pike, K. M., & Walsh, B. T. (in press). Anorexia Nervosa. In J.E. Fisher & W. O’Donohue (Eds.), Practice Guidelines for Evidence Based Psychotherapy. New York: Kluwer Academic.