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Internet-based cognitive-behavioral therapy for bulimia nervosa: a controlled study.

Fernando Fernández-Aranda1, Araceli Núñez, Cristina Martínez

  • 1Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain. ffernandez@bellvitgehospital.cat

Cyberpsychology & Behavior : the Impact of the Internet, Multimedia and Virtual Reality on Behavior and Society
|November 14, 2008
PubMed
Summary

Internet-based therapy (IBT) shows effectiveness for bulimia nervosa (BN) compared to a waiting list. This online self-help approach is a valid treatment option, particularly for individuals with less severe eating disorder symptoms.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Behavioral Science

Background:

  • Bulimia nervosa (BN) is a serious eating disorder (ED) requiring effective treatment options.
  • Internet-based therapy (IBT) offers a potentially accessible modality for BN treatment.

Purpose of the Study:

  • To evaluate the efficacy of an Internet-based therapy (IBT) for bulimia nervosa (BN) against a waiting list (WL) control group.
  • To identify predictors of treatment success and factors associated with dropout in BN patients undergoing IBT.

Main Methods:

  • Sixty-two female BN patients were randomized to either IBT or a WL.
  • Standardized assessments (EDI, SCL-90-R, BITE, TCI-R) were administered pre- and post-treatment.
  • Matched control participants (WL) ensured comparability in key demographic and clinical variables.

Main Results:

  • IBT group showed significant reductions in some eating disorder inventory (EDI) and binge-eating (BITE) symptom scores.
  • Mean Body Mass Index (BMI) increased post-IBT, and bingeing/vomiting abstinence rates differed significantly from the WL group.
  • Predictors of positive IBT outcome included higher perfectionism (EDI) and EAT scores, and higher minimum BMI. Dropout was linked to higher anxiety (SCL) and lower reward dependence (TCI).

Conclusions:

  • Internet-based therapy (IBT) is a viable treatment for bulimia nervosa (BN) compared to a waiting list (WL).
  • IBT may be most effective for individuals with lower eating disorder (ED) severity and specific personality traits.
  • Understanding predictors and dropout factors can help optimize online interventions for BN.