The Treatment of Bulimia Nervosa: Which Regimen Is Most Efficacious? An Analysis of the Evidence for Physician Assistants and Primary Care Providers Treating Eating Disorders

Abstract

Bulimia nervosa is a serious disorder with significant morbidity and mortality if left untreated. It is therefore imperative that an effective treatment be initiated. The two categories of therapy currently used are psychotherapy and pharmacotherapy. Cognitive behavioral therapy has long been advocated as the treatment of choice. However, there has been research into the efficacy of the selective serotonin reuptake inhibitors for the treatment of bulimia. The results of this review suggest that while antidepressants may have a role in the treatment of some of the comorbid symptoms of bulimia, they do not significantly alter the underlying factors such as disturbed attitudes about shape and weight. In addition, it has not been shown that pharmucotherapy elicits a durable response after cessation of the drug. Therefore psychotherapy, preferably in the form of cognitive behavioral therapy or interpersonal psychotherapy, is the treatment of choice for bulimia nervosa.