Cognitive Behavioral Therapy for Binge Eating Based on the Addictive Appetite Model and Specialist Supportive Clinical Management with Adjunct Motivational Enhancement Therapy for Patients with Bulimia Nervosa: A Feasibility Study.

BACKGROUND

While cognitive behavioral therapy (CBT) is the first-line treatment for bulimia nervosa (BN), standardizing treatment approaches may create differences in acceptability and efficacy between Wester and non-Western countries.

METHODS

The retrospective cohort study investigated the feasibility and effectiveness of psychological therapies for BN in a Korean population. A total of 227 Korean patients with BN from a university hospital were included. Of these, 125 received CBT for binge eating based on the addictive appetite model, while 102 received specialist supportive clinical management for BN (SSCM for BN). Both therapies were accompanied by motivational enhancement therapy to enhance adherence. We conducted a mixed analysis of variance to examine the effects of two psychotherapies.

RESULTS

There were main effects of time, with decreases in BN behaviors at post-treatment showing small effects (η2 ranged from 0.02 to 0.19) and decreases in eating disorder psychopathology showing moderate effects (η2 ranged from 0.27 to 0.54). The SSCM for BN group attended more sessions (27.3%; 15.66±14.08 sessions) than the CBT for binge eating group (39.7%; 10.86±11.80 sessions), while the dropout rate did not significantly differ between groups. In the regression analyses, the number of treatment sessions was associated with an increased likelihood of full remission (odds ratio, 1.119; P=0.003).

CONCLUSION

Both therapies were effective in reducing BN pathology in Korean patients with BN. The results suggest the need for personalization in the treatment of BN to enhance acceptability and efficacy, particularly in ethnic minorities.