Eating disorders in over 8s: management

National Institute for Health and Care Excellence

Bulimia nervosa

Following the initial assessment consider:

  • As a possible first step, an evidence-based self-help programme – direct encouragement and support to patients undertaking such a programme may improve outcomes. This may be sufficient treatment for a limited subset of patients

Psychological treatment should form the key element of treatment, so consider:

  • For adults: cognitive behaviour therapy for bulimia nervosa (CBT-BN), which should normally be 16–20 sessions over 4–5 months
  • For adolescents: CBT-BN adapted as needed to suit their age, circumstances and level of development
  • Where there has been no response to CBT or it has been declined: other psychological treatments, particularly interpersonal psychotherapy (IPT). (Note: patients should be informed that IPT takes 8–12 months to achieve results comparable with CBT-BN)

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