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Cited by 37Eating Disorders and BehaviorsNutrition, Health and Food BehaviorAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

The role of regular eating and self-monitoring in the treatment of bulimia nervosa: a pilot study of an online guided self-help CBT program

Open access
Barakat, Sarah, Maguire, Sarah, Surgenor, Lois, Donnelly, Brooke, Miceska, Blagica, Fromholtz, Kirsty, Russell, Janice, Hay, Phillipa +1 more·2017·Behavioral Sciences
DOI 10.3390/bs7030039PMC PMC5618047
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Abstract

Background: Despite cognitive behavioural therapy (CBT) being regarded as the first-line treatment option for bulimia nervosa (BN), barriers such as its time-consuming and expensive nature limit patient access. In order to broaden treatment availability and affordability, the efficacy and convenience of CBT could be improved through the use of online treatments and selective emphasis on its most ‘potent’ components of which behavioural techniques form the focus. Method: Twenty-six individuals with BN were enrolled in an online CBT-based self-help programme and 17 completed four weeks of regular eating and food-monitoring using the online Food Diary tool. Participants were contacted for a weekly check-in phone call and had their bulimic symptom severity assessed at five time points (baseline and weeks 1–4). Results: There was a significant decrease in the frequency of self-reported objective binge episodes, associated loss of control and objective binge days reported between pre- and post-treatment measures. Significant improvements were also observed in most subscales of the Eating Disorder Examination-Questionnaire. Conclusion: This study provides encouraging preliminary evidence of the potential of behavioural techniques of online CBT in the treatment of BN. Online therapy with this focus is potentially a viable and practical form of treatment delivery in this illness group. These preliminary findings support the need for larger studies using control groups.

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  • The marked slowing in the rate of change at this juncture further supports the theory that behavioural techniques introduced in the preliminary sessions of CBT treatment (i.e., weekly weighing, self-monitoring of food intake, regular eating) may facilitate early and rapid symptom change.

    “A marked slowing in the rate of change at this juncture further supports the theory that behavioural techniques introduced in the preliminary sessions of CBT treatment (i.e., weekly weighing, self-monitoring of food intake, regular eating) may facilitate early and rapid symptom change (34, 53, 54).”

    From The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder (2023) · cites this paper as [54]

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  • The dropout rate (26%) was lower than the average rate of 32% estimated in a meta-analysis of BED eTherapies and comparable to the rates of 21 and 16% found in the pilots of the briefer, four-session version of this eTherapy in individuals with BED and BN.

    “The dropout rate (26%) was lower than the average rate of 32% estimated in a meta-analysis of BED eTherapies (57) and comparable to the rates of 21 and 16% found in the pilots of the briefer, four-session version of this eTherapy in individuals with BED and BN (32, 54).”

    From The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder (2023) · cites this paper as [54]

    Results §3.2 (page unavailable) reports 16% dropout among participants with BN, supporting the rate attributed to this pilot. But Methods §§2.2 and 2.4 describe a ten-session program in which the study tested Session 1 followed by four weeks of monitoring—not a four-session version. Results §3.2 separately reports another 16% who began but did not complete the monitoring period. (LLM, conf=0.88)

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Research works printed but not linked: 5

  1. [2]National Collaborating Centre for Mental Health Eating Disorders: Core Interventions in the Treatment and Management of Anorexia Nervosa, Bulimia Nervosa and Related Eating Disorders NICE guideline (CG9) British Psychological Society Leicester, UK Royal College of Psychiatrists London, UK 2004 23346610
  2. [4]National Eating Disorders Collaboration (NEDC) Eating Disorders Prevention, Treatment and Management: An Evidence Review Commissioned by the Commonwealth Department of Health and Aging National Eating Disorders Collaboration Canberra, Australia 2010
  3. [11]Fairburn C.G. Overcoming Binge Eating 1st ed. Guilford Press New York, NY, USA 1995
  4. [26]Fairburn C.G. Cooper Z. The Eating Disorder Examination (12th ed.) Binge Eating: Nature, Assessment and Treatment Fairburn C.G. Wilson G.T. Guilford Press New York, NY, USA 1993 317 360
  5. [53]Fairburn C.G. Beglin S.J. Eating Disorder Examination Questionnaire (6.0) Cognitive Behavior Therapy and Eating Disorders Fairburn C.G. Guildford Press New York, NY, USA 2008 309 315

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Authors
Barakat, S., Maguire, S., Surgenor, L., Donnelly, B., Miceska, B., Fromholtz, K., Russell, J., Hay, P., & Touyz, S.
Affiliations
  • The University of Sydney (AU)
  • University of Otago (NZ)
  • Sydney Local Health District (AU)
  • Western Sydney University (AU)
Corresponding author
Barakat, Sarah
ORCID
Venue
Behavioral Sciences
Publisher
MDPI AG
Published
2017-06-26
Volume
7
Issue
3
Pages
39
ISSN
2076-328X (ISSN-L)
DOI
10.3390/bs7030039
PMC
PMC5618047
OpenAlex
W2631645275
Cited by
37
References
75
Citations by year
2026: 2 · 2025: 2 · 2024: 4 · 2023: 8 · 2022: 10 · 2021: 3 · 2020: 4 · 2019: 2 · 2018: 1
FWCI
2.37
Type
journal article
Language
en
Open access
Licence
Locations
  • Behavioral Sciences (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
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, cognitive behavioral therapy, online self-help, guided self-help, food diary, binge eating, loss of control, treatment accessibility, Eating Disorder Examination Questionnaire

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