Web-based cognitive behavioural therapy may be effective for treatment of bulimia nervosa

1. Patients with bulimia nervosa randomized to receive web-based cognitive behavioural therapy (CBT) were observed to experience fewer bulimic episodes and binge-eating episodes compared to control, and may be a viable and more accessible alternative to in-person CBT. 

Evidence Rating Level: 1 (Excellent) 

Despite 1-2% of the global population being affected by bulimia nervosa (BN) during their lifetime, accessing evidence-based treatments can be difficult due to logistical barriers. Cognitive behavioural therapy (CBT) has been shown to be a viable intervention for BN. If barriers such as in-person meetings were reduced through web-based interventions, more patients could be treated in a timely manner. This randomized clinical trial compared a 12-week, web-based CBT intervention to no intervention. 154 individuals were blindly put into either group. Both groups had similar demographic characteristics and clinical baselines. The intervention group saw fewer bulimic episodes (p < 0.001). The control group did not see a reduction in bulimic episodes. Binge-eating episodes were also reduced in the intervention group (p <0.001). No changes in either group were seen regarding compensatory behaviours. Weekly symptom measurements were also lower in the intervention group when compared to the control group (p = 0.005). However, given the study only compared intervention to no intervention, less is known regarding the relative efficacy of web-based CBT compared to traditional treatment programs. As such, further research is required to determine whether or not web-based CBT would provide comparable efficacy to in-person programs. Nonetheless however, for patients with limited healthcare access, web-based CBT may be a viable option to improve outcomes for BN.

Click to read the study in JAMA Network Open  

Image: PD

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