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Dialectical behavior therapy adapted for bulimia: a case report.

D L Safer1, C F Telch, W S Agras

  • 1Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California 94305-5722, USA.

The International Journal of Eating Disorders
|July 6, 2001
PubMed
Summary
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Dialectical behavior therapy (DBT) effectively treated bulimia nervosa by teaching emotion regulation skills. The patient achieved and maintained abstinence from binge eating and purging after 20 sessions.

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Behavioral Therapy

Background:

  • Bulimia nervosa is a complex eating disorder often resistant to traditional counseling.
  • Eating disorders are frequently linked to difficulties in emotion regulation.

Observation:

  • A 36-year-old woman with a history of treatment-resistant bulimia nervosa (binge eating and purging) participated in a 20-session manualized therapy.
  • Prior to treatment, the patient exhibited significant binge eating (13 episodes) and purging (21 episodes) within a 4-week period.

Findings:

  • The application of dialectical behavior therapy (DBT), grounded in an affect regulation model, led to a rapid decline in binge eating and purging.
  • The patient achieved and maintained abstinence from binge eating and purging by the fifth week of DBT treatment.

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  • Post-treatment follow-up indicated sustained remission, with only two binge and two purge episodes reported in the subsequent six months.

    • Implications:

    • Manualized dialectical behavior therapy (DBT) presents a promising, structured intervention for bulimia nervosa.
    • Teaching emotion regulation skills is a key component in successfully managing and overcoming eating disorders.
    • This case report highlights the potential of DBT as an effective treatment for individuals with severe and persistent bulimia nervosa.