NEDA TOOLKIT for Parents
C — Psychiatric admission for people with bulimia
nervosa should normally be undertaken in a setting
with experience of managing this disorder.
C — Health care professionals should be aware that
patients with bulimia nervosa who have poor impulse
control, notably substance misuse, may be less likely
to respond to a standard program of treatment. As a
consequence treatment should be adapted to the
problems presented.
Additional Considerations for Children and
Adolescents C — Adolescents with bulimia nervosa may be treated
with CBT-BN adapted as needed to suit their age,
circumstances, and level of development, and
including the family as appropriate.
General Treatment of Atypical Eating
Disorders C — In the absence of evidence to guide the
management of atypical eating disorders (eating
disorders not otherwise specified) other than binge
eating disorder, it is recommended that the clinician
considers following the guidance on the treatment of
the eating problem that most closely resembles the
individual patient’s eating disorder.
Psychological Treatments for Binge Eating
Disorder B — Other psychological treatments (interpersonal
psychotherapy for binge eating disorder and modified
dialectical behavior therapy) may be offered to adults
with persistent binge eating disorder.
A — Patients should be informed that all
psychological treatments for binge eating disorder
have a limited effect on body weight.
C — When providing psychological treatments for
patients with binge eating disorder, consideration
should be given to the provision of concurrent or
consecutive interventions focusing on the
management of comorbid obesity.
C — Suitably adapted psychological treatments
should be offered to adolescents with persistent binge
eating disorder.
Pharmacological Interventions for Binge
Eating Disorder
B — As an alternative or additional first step to using
an evidence based self-help program, consideration
should be given to offering a trial of an SSRI
antidepressant drug to patients with binge eating
disorder. B — Patients with binge eating disorders should be
informed that SSRIs can reduce binge eating, but the
long-term effects are unknown. Antidepressant drug
treatment may be sufficient treatment for a limited
subset of patients.
B — As a possible first step, patients with binge eating
disorder should be encouraged to follow an evidence
based self-help program.
Definitions: Evidence Categories
B — Health care professionals should consider
providing direct encouragement and support to
patients undertaking an evidence-based self-help
program as this may improve outcomes. This may be
sufficient treatment for a limited subset of patients.
I: Evidence obtained from a single randomized
controlled trial or a meta-analysis of randomized
controlled trials
IIA: Evidence obtained from at least one well-designed
controlled study without randomization
IIB: Evidence obtained from at least one well-designed
quasiexperimental study
III: Evidence obtained from well-designed non-
experimental descriptive studies, such as comparative
studies, correlation studies, and case-control studies
IV: Evidence obtained from expert committee reports
or opinions and/or clinical experience of respected
authorities A — Cognitive behavior therapy for binge eating
disorder (CBTBED), a specifically adapted form of CBT,
should be offered to adults with binge eating disorder.
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