Self-help for Bulimia and BED

In Great Britain, the shortage of skilled therapists to treat people with bulimia nervosa and binge eating disorder has led researchers to search for treatment alternatives. A guided self-help program might offer an alternative treatment in a primary care setting, according to a group at Leicester Warwick Medical School, Leicester, UK (Br J Psychiatry 2002;181:230).

The British researchers investigated the effectiveness of self-help alone, self-help with face-to-face counseling, and counseling by telephone alone. They used a randomized controlled study comparing the three forms of self-help over 4 months with a comparison group of patients on a waiting list for treatment (control group).

Self-help delivered over four sessions with face-to-face counseling led to improved outcome after 4 months. They also found some evidence to support the use of guidance by telephone. A few patients had lasting remission in comparison to those receiving more intense counseling with self-help, but there was no significant difference in outcome between the groups after they had finished the stepped-care program. Those who had initially been offered guided self-help did have a lower long-term dropout rate.