Nonpharmacologic treatments of bulimia nervosa.

The principal psychosocial approach to the treatment of bulimia nervosa has been cognitive-behavioral therapy, the effectiveness of which has been extensively documented in controlled trials, with full recovery (cessation of binge eating and purging) in some 50% to 60% of patients. More recently, interpersonal therapy, first introduced for the treatment of depression, has been shown in preliminary studies to be as effective as cognitive-behavioral therapy, particularly at follow-up. The evidence for effectiveness of psychosocial therapies in bulimia nervosa is first reviewed, and consideration is then given to what is known concerning the combination of psychosocial and psychopharmacologic treatment approaches and to the overall implications for the treatment of bulimia nervosa.