Cognitive behavioral therapy as an evidence-based treatment for bulimia nervosa

Abstract

Bulimia nervosa (BN) presents significant psychological, behavioural, and physical challenges, often co-occurring with psychiatric conditions such as depression, PTSD, and ADHD, which can worsen prognosis and psychosocial functioning. This narrative review explores the efficacy of cognitive-behavioural therapy for bulimia nervosa (CBT-BN) as an evidence-based treatment, contrasting its rapid symptom improvement with traditional approaches like psychoanalytic psychotherapy. Studies consistently show that CBT-BN offers substantial reductions in binge eating and purging within a short treatment duration, making it an efficient and effective intervention. Key to its success is the structured targeting of dietary restraint and cognitive distortions that drive the binge-purge cycle. Group CBT also emerges as a promising, cost-effective alternative with comparable efficacy to individual CBT, suggesting potential for broader accessibility. Despite the positive outcomes, access to specialized CBT-BN practitioners remains limited, underscoring the need for scalable models such as group therapy. This review highlights CBT-BN's potential as a comprehensive, impactful approach that addresses primary and secondary symptoms of BN and offers enduring benefits for affected individuals.