The British Journal of Psychiatry 159: 250-261 (1991)
© 1991 The Royal College of Psychiatrists
A comparison of nutritional management with stress management in the treatment of bulimia nervosa
RG Laessle, PJ Beumont, P Butow, W Lennerts, M O'Connor, KM Pirke, SW Touyz and S Waadt
Division of Psychoneuroendocrinology, Max Planck Institute for Psychiatry, Munich.
In a comparison of nutritional management (NM) and stress management (SM)
for treatment of bulimia nervosa, 55 female patients were randomly assigned
to either treatment. Therapy consisted of 15 sessions in a group over three
months, by the end of which, patients under both treatment conditions
showed a significant reduction in the frequency of binge eating and
vomiting and a significant improvement in various psychopathological
features such as body dissatisfaction and depression. All improvements were
maintained over 12-month follow-up NM produced a more rapid improvement in
general eating behaviour, a faster reduction in binge frequency and a
higher abstinence rate from binge eating. SM led to greater positive
changes in certain psychopathological features such as feelings of
ineffectiveness, interpersonal distrust and anxiety. NM should be regarded
as a necessary first intervention in all bulimic patients. Further
psychological therapy, such as SM, is indicated as well for some patients,
depending on their specific psychological difficulties.
