Relapse Predictors of Patients With Bulimia Nervosa Who Achieved Abstinence Through Cognitive Behavioral Therapy
Abstract
Background Little information exists on relapse in patients with bulimia nervosa who responded with complete abstinence from binge eating and purging to cognitive behavioral therapy. Identification of relapse predictors may be useful to design effective early intervention strategies for relapse of susceptible patients with bulimia nervosa. Methods This multisite study examined relapse in 48 patients with bulimia nervosa who had responded to cognitive behavioral therapy with complete abstinence from binge eating and purging. Structured interviews and questionnaires were used to assess patients before and after treatment and at 4 months after treatment. Results Four months after treatment, 44% of the patients had relapsed. Those who relapsed had a higher level of preoccupation and ritualization of eating and less motivation for change, and had maintained abstinence for a shorter time during the treatment period. Conclusions The predictors of relapse found in this study can be readily determined by clinicians. The effectiveness of early additional treatment interventions needs to be determined with well-designed studies of large samples.
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Up to 50% of patients with bulimia nervosa have residual symptoms after treatment, and relapse is common.
“however up to 50% of patients with BN have residual symptoms after treatment and relapse is common (Halmi et al., 2002; Keel et al., 1999)”
From Early reduction in anxiety sensitivity predicts greater reduction in disordered eating and trait anxiety during treatment for bulimia nervosa. (2024) · cites this paper as Halmi et al., 2002
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Postremission predictors of relapse in women with eating disorders
Keel, P. K., Dorer, D. J., Franko, D. L., Jackson, S. C., & Herzog, D. B. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.12.2263 · Cited by 417 · see citing works
Bingeing rats: A model of intermittent excessive behavior?
Corwin, R. L. (2006) · Appetite · doi:10.1016/j.appet.2004.09.002 · Cited by 134 · see citing works
Ebert, D., Tarnowski, T., Gollwitzer, M., Sieland, B., & Berking, M. (2013) · Psychotherapy and Psychosomatics · doi:10.1159/000345967 · Cited by 93 · see citing works
Ebert, D. D., Gollwitzer, M., Riper, H., Cuijpers, P., Baumeister, H., & Berking, M. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2511 · Cited by 61 · see citing works
Martinez, E., Castro, J., Bigorra, A., Morer, A., Calvo, R., Vila, M., Toro, J., & Rieger, E. (2007) · European Eating Disorders Review · doi:10.1002/erv.725 · Cited by 34 · see citing works
Kissileff, H. R., Brunstrom, J. M., Tesser, R., Bellace, D., Berthod, S., Thornton, J. C., & Halmi, K. (2016) · Appetite · doi:10.1016/j.appet.2015.11.026 · Cited by 23 · see citing works
Self-citationVelkoff, E. A., Rubino, L. G., Liu, J., Manasse, S. M., & Juarascio, A. S. (2024) · International Journal of Eating Disorders · doi:10.1002/eat.24207 · Cited by 5 · see citing works
- Authors
- Halmi, K. A., Agras, W. S., Mitchell, J., Wilson, G. T., Crow, S., Bryson, S. W., & Kraemer, H.
- Affiliations
- Cornell University (US)
- Stanford University (US)
- Rutgers Cancer Institute (US)
- ORCID
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2002-12-01
- Volume
- 59
- Issue
- 12
- Pages
- 1105
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W1967546121
- Cited by
- 99
- References
- 0
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 5 · 2022: 1 · 2021: 5 · 2020: 1 · 2019: 2 · 2018: 3 · 2017: 6 · 2016: 3 · 2015: 6 · 2014: 4 · 2013: 6 · 2012: 7
- FWCI
- 8.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- bulimia nervosa, relapse, predictors of relapse, cognitive behavioral therapy, binge eating, purging, abstinence, motivation for change, early intervention
- MeSH terms
- Adolescent, Adult, Bulimia, Depressive Disorder, Female, Follow-Up Studies, Humans, Motivation, Patient Compliance, Personality Assessment, Personality Disorders, Recurrence, Risk Factors, Comorbidity, Cognitive Behavioral Therapy
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