Bulimia nervosa: treatment for adults

Guided self-help

If you have bulimia you may be offered a guided self-help programme. This means working through a book about bulimia, and having short sessions with a practitioner (such as a therapist) to check how you are doing. People generally have between 4 and 9 sessions that last about 20 minutes each. However, you and your practitioner should agree how many sessions to have and how long they will last, depending on what works for you.

Guided self-help is often helpful but it isn't right for everyone. If you feel it hasn't helped after 4 weeks, you may be offered cognitive behavioural therapy (CBT).

Cognitive behavioural therapy

If you're offered CBT you should expect to have up to 20 sessions over 20 weeks (4 to 5 months). To start with you should see your practitioner twice a week. You can also choose to involve people close to you in your therapy.

What does it involve?

The practitioner should support and encourage you to adopt regular eating habits. They should help you address the difficult thoughts and feelings that trigger your binge-eating, and the way you feel about your weight and shape. They should show you how to stick to your new eating habits after your therapy ends, including at times when this feels very difficult (this is called relapse prevention).

Reaching a healthy weight

Your body weight is unlikely to change much during your therapy because it is not designed to help you lose or gain weight. If you need to reach a healthy weight, you should expect this to be a longer-term part of your recovery. Your practitioner can give you more advice about this.