Treatments for bulimia nervosa: a network meta-analysis.
About this resource
BACKGROUND: Bulimia nervosa (BN) is a severe eating disorder that can be managed using a variety of treatments including pharmacological, psychological, and combination treatments. We aimed to compare their effectiveness and to identify the most effective for the treatment of BN in adults. METHODS: A search was conducted in Embase, Medline, PsycINFO, and Central from their inception to July 2016. Studies were included if they reported on treatments for adults who fulfilled diagnostic criteria for BN. Only randomised controlled trials (RCTs) that examined available psychological, pharmacological, or combination therapies licensed in the UK were included. We conducted a network meta-analysis (NMA) of RCTs. The outcome analysed was full remission at the end of treatment. RESULTS: We identified 21 eligible trials with 1828 participants involving 12 treatments, including wait list. The results of the NMA suggested that individual cognitive behavioural therapy (CBT) (specific to eating disorders) was most effective in achieving remission at the end of treatment compared with wait list (OR 3.89, 95% CrI 1.19-14.02), followed by guided cognitive behavioural self-help (OR 3.81, 95% CrI 1.51-10.90). Inconsistency checks did not identify any significant inconsistency between the direct and indirect evidence. CONCLUSIONS: The analysis suggested that the treatments that are most likely to achieve full remission are individual CBT (specific to eating disorders) and guided cognitive behavioural self-help, although no firm conclusions could be drawn due to the limited evidence base. There is a need for further research on the maintenance of treatment effects and the mediators of treatment outcome.
Mortality and its predictors in severe bulimia nervosa patients
Background: The risk of mortality remains unclear for bulimia nervosa (BN) patients, especially the most severe.Read more
Cognitive-Behavioral and Psychodynamic Therapy in Female Adolescents With Bulimia Nervosa: A Randomized Controlled Trial.
OBJECTIVE: The authors compared cognitive-behavioral therapy (CBT) and psychodynamic therapy (PDT) for the treatment of bulimia nervosa (BN) in female adolescents.Read more
Disordered eating in girls with Type 1 diabetes: Examining directions for prevention
Girls with Type 1 diabetes (insulin-dependent diabetes mellitus [IDDM]) have been identified to be at an increased risk for developing bulimia nervosa (BN) and subthreshold eating disorders.Read more
Eating disorders: Clinical features and pathophysiology
Anorexia nervosa (AN) and bulimia nervosa (BN) are disorders of eating and weight-related behavior that together afflict some 1-3 % of women in the United States.Read more