Cognitive behavioral intervention reduces eating disorder symptoms in bulimia nervosa: Study

A recent study published in the Journal of American Medical Association suggests that integrating digital interventions into routine care could help reach more patients and reduce the clinical burden associated with bulimia nervosa (BN).

This 2-group randomized clinical trial analyzed the effectiveness of a web-based cognitive behavioral self-help intervention for individuals with BN. The trial conducted in Germany from February 2, 2021 to July 9, 2022 included participants of 18 to 65 years old who fulfilled the diagnostic criteria for BN. The participants enrolled online through self-referral and data analyses were conducted from October 24, 2022 to December 23, 2023.

The intervention consisted of a web-based cognitive behavioral self-help program that included 12 weekly modules and this was compared to a waiting-list control group that only had access to routine care. The primary outcome analyzed was the change in the number of bulimic episodes between baseline and posttreatment. The secondary outcomes included changes in global eating disorder symptoms, clinical impairment, well-being, work capacity, comorbid symptoms, self-esteem and emotion regulation which were complemented by weekly measures and ecological momentary assessment.

The study involved a total of 154 participants with a mean age of 29.6 years, of which 96.8% were female. The results indicated that the participants who were receiving the web-based intervention showed a significantly greater decrease in bulimic episodes when compared to the control group. The intervention group demonstrated a Cohen d of −0.48 for bulimic episodes and a Cohen d of −0.61 for binge-eating episodes. Also, no significant changes were observed in the compensatory behaviors (Cohen d = −0.25; 95% CI, −0.51 to 0.02; P = .21). This intervention was superior in enhancing the global eating disorder symptoms and clinical impairment. Also, there were no significant effects observed on well-being and work capacity.

Further in depth analyses found significant improvements in self-esteem and emotion regulation issues among the intervention group. Also, no significant changes were found in comorbid symptoms which suggested that while the web-based intervention was effective in addressing core eating disorder symptoms and related impairments, it did not impact other co-occurring psychological issues.

The outcomes highlights the effectiveness of a web-based cognitive behavioral self-help intervention in reducing eating disorder symptoms and the disease-related burden in individuals with BN. Overall, these findings illuminate the potential of digital interventions to complement established treatments and provide better access to care for the patients with bulimia nervosa.

Source:

Hartmann, S., Timm, C., Barnow, S., Rubel, J. A., Lalk, C., & Pruessner, L. (2024). Web-Based Cognitive Behavioral Treatment for Bulimia Nervosa. In JAMA Network Open (Vol. 7, Issue 7, p. e2419019). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2024.19019