Empowerment of women with purging-type bulimia nervosa through nutritional rehabilitation.

Since the primary role of psychoeducation in eating disorders is to act as a foundation for other interventions, nutritional rehabilitation should use the same therapeutic principles as psychotherapy. This paper looks at the possibility that traditional psychoeducational results can be enhanced in patients with bulimia nervosa by a new nutritional rehabilitation programme focused on psychobiological reorganization of eating behaviour as opposed to the prescription of regular eating patterns. Forty women with purging-type bulimia nervosa were enrolled for a 24-week experimental period of cognitive-behavioural psychotherapy (CBT) and were randomly and evenly divided into two groups to follow a psychobiological nutritional rehabilitation (PNR) and a traditional nutritional rehabilitation (TNR) programme respectively. The follow-up period averaged 6 months; four subjects dropped out. The baselines of both groups were comparable with regard to key features, including binge and vomiting frequency, and carbohydrate and lipid intake. Both groups improved significantly over time, though improvements in bingeing and vomiting and lipid intake were greater in the PNR group (p < 0.001), both at the end of the study and at the follow-up. This psychobiological approach to appetite and weight control may constitute a theoretical framework facilitating the application of cognitive-behavioural guidelines to both nutritional rehabilitation and psychotherapy.