Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jun 26;7(3):39.
doi: 10.3390/bs7030039.

The Role of Regular Eating and Self-Monitoring in the Treatment of Bulimia Nervosa: A Pilot Study of an Online Guided Self-Help CBT Program

Sarah Barakat  1 , Sarah Maguire  2 , Lois Surgenor  3 , Brooke Donnelly  4 , Blagica Miceska  5 , Kirsty Fromholtz  6 , Janice Russell  7 , Phillipa Hay  8 , Stephen Touyz  9
Affiliations

The Role of Regular Eating and Self-Monitoring in the Treatment of Bulimia Nervosa: A Pilot Study of an Online Guided Self-Help CBT Program

Sarah Barakat et al. Behav Sci (Basel). .

Abstract

Background: Despite cognitive behavioural therapy (CBT) being regarded as the first-line treatment option for bulimia nervosa (BN), barriers such as its time-consuming and expensive nature limit patient access. In order to broaden treatment availability and affordability, the efficacy and convenience of CBT could be improved through the use of online treatments and selective emphasis on its most 'potent' components of which behavioural techniques form the focus. Method: Twenty-six individuals with BN were enrolled in an online CBT-based self-help programme and 17 completed four weeks of regular eating and food-monitoring using the online Food Diary tool. Participants were contacted for a weekly check-in phone call and had their bulimic symptom severity assessed at five time points (baseline and weeks 1-4). Results: There was a significant decrease in the frequency of self-reported objective binge episodes, associated loss of control and objective binge days reported between pre- and post-treatment measures. Significant improvements were also observed in most subscales of the Eating Disorder Examination-Questionnaire. Conclusion: This study provides encouraging preliminary evidence of the potential of behavioural techniques of online CBT in the treatment of BN. Online therapy with this focus is potentially a viable and practical form of treatment delivery in this illness group. These preliminary findings support the need for larger studies using control groups.

Keywords: bulimia nervosa; cognitive behavioural therapy; objective binge episodes; online treatment; purging; regular eating; self-monitoring.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Figures

Figure 1
Figure 1
Flowchart of study participants.
Figure 2
Figure 2
Schematic of the timing and sequence of assessments and included measures. Note: Week one, week two and week three assessments were identical. EDE-Q = Eating Disorder Examination-Questionnaire; K10 = Kessler Psychological Distress Scale; EDQOL = Eating Disorder Quality of Life Scale; TFEQ = Three Factor Eating Questionnaire.
See this image and copyright information in PMC

References

    1. Hay P., Chinn D., Forbes D., Madden S., Newton R., Sugenor L., Touyz S., Ward W. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders. Aust. N. Z. J. Psychiatry. 2014;48:977–1008. doi: 10.1177/0004867414555814. - DOI - PubMed
    1. National Collaborating Centre for Mental Health . Eating Disorders: Core Interventions in the Treatment and Management of Anorexia Nervosa, Bulimia Nervosa and Related Eating Disorders. British Psychological Society; Leicester, UK: Royal College of Psychiatrists; London, UK: 2004. NICE guideline (CG9) - PubMed
    1. Hart L.M., Granillo M.T., Jorm A.F., Paxton S.J. Unmet need for treatment in the eating disorders: A systematic review of eating disorder specific treatment seeking among community cases. Clin. Psychol. Rev. 2011;31:727–735. doi: 10.1016/j.cpr.2011.03.004. - DOI - PubMed
    1. National Eating Disorders Collaboration (NEDC) Eating Disorders Prevention, Treatment and Management: An Evidence Review. National Eating Disorders Collaboration; Canberra, Australia: 2010. Commissioned by the Commonwealth Department of Health and Aging.
    1. Tobin D.L., Banker J.D., Weisberg L., Bowers W. I know what you did last summer (and it was not CBT): A factor analytic model of international psychotherapeutic practice in the eating disorders. Int. J. Eat. Disord. 2007;40:754–757. doi: 10.1002/eat.20426. - DOI - PubMed

LinkOut - more resources