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Cognitive behavioral therapy CBT , which involves teaching a person to challenge automatic thoughts and engage in behavioral experiments for example, in session eating of "forbidden foods" has a small amount of evidence supporting its use.
By using CBT people record how much food they eat and periods of vomiting with the purpose of identifying and avoiding emotional fluctuations that bring on episodes of bulimia on a regular basis.
He states in order for the therapy to work, all parties must work together to discuss, record and develop coping strategies. Barker claims by making people aware of their actions they will think of alternatives.
Maudsley family therapy , developed at the Maudsley Hospital in London for the treatment of anorexia has been shown promising results in bulimia.
The use of Cognitive Behavioral Therapy CBT has been shown to be quite effective for treating bulimia nervosa BN in adults, but little research has been done on effective treatments of BN for adolescents.
Adolescents are at the stage where their brains are still quite malleable and developing gradually. Antidepressants of the selective serotonin reuptake inhibitors SSRI class may have a modest benefit.
Topiramate may also be useful but has greater side effects. It is not known if combining medication with counseling improves the outcomes. Any trials which originally suggested that such combinations should improve the outcome have not proven to be exceptionally powerful.
Some positive outcomes of treatments can include: Some researchers have also claimed positive outcomes in hypnotherapy. There is little data on the percentage of people with bulimia in general populations.
Most studies conducted thus far have been on convenience samples from hospital patients, high school or university students.
These have yielded a wide range of results: Bulimia nervosa occurs more frequently in developed countries  and in cities, with one study finding that bulimia is five times more prevalent in cities than in rural areas.
There are higher rates of eating disorders in groups involved in activities which idealize a slim physique, such as dance,  gymnastics, modeling, cheerleading , running, acting, swimming, diving, rowing and figure skating.
Bulimia is thought to be more prevalent among Caucasians ;  however, a more recent study showed that African-American teenage girls were 50 percent more likely than white girls to exhibit bulimic behavior, including both binging and purging.
Although diagnostic criteria for bulimia nervosa did not appear until , evidence suggests that binging and purging were popular in certain ancient cultures.
C, in which Greek soldiers purged themselves in the mountains of Asia Minor. It is unclear whether this purging was preceded by binging.
In ancient Rome, elite society members would vomit in order to "make room" in their stomachs for more food at all day banquets.
Historical records also suggest that some saints who developed anorexia as a result of a life of asceticism may also have displayed bulimic behaviors.
Catherine died from starvation at age thirty-three. While the psychological disorder "bulimia nervosa" is relatively new, the word "bulimia," signifying overeating, has been present for centuries.
There was no evidence of deliberate vomiting or an attempt to control weight. At the turn of the century, bulimia overeating was described as a clinical symptom, but rarely in the context of weight control.
In , admissions of anorexia nervosa patients to the Mayo Clinic from to were compiled. Fifty-five to sixty-five percent of these patients were reported to be voluntarily vomiting in order to relieve weight anxiety.
Several case studies from this era reveal patients suffering from the modern description of bulimia nervosa. Ellen West , a patient described by Ludwig Binswanger in , was teased by friends for being fat and excessively took thyroid pills to lose weight, later using laxatives and vomiting.
After being admitted to a psychiatric facility for depression, Ellen ate ravenously yet lost weight, presumably due to self-induced vomiting.
The s, however, truly introduced the trend of an aspiration for thinness. In , Gerald Russell first published a description of bulimia nervosa, in which he studied patients with a "morbid fear of becoming fat" who overate and purged afterwards.
In , Kendler et al. From Wikipedia, the free encyclopedia. The American Journal of Psychiatry. Expert Opinion on Pharmacotherapy. An ominous variant of anorexia nervosa".
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Eating a large amount of food in a casino lizenzfrei amount of time followed by vomiting or the use of laxativesoften normal weight  .
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