Study of Treatment for Adolescents With Bulimia Nervosa
Condition: Bulimia
MeSH terms: Bulimia; Bulimia Nervosa
Study type: Interventional

Summary: 
      In the face of scant literature on the subject, the investigators aim to more clearly
      identify effective treatments for adolescent bulimia nervosa (BN) through a treatment study
      comparing two current treatments (Cognitive Behavioral Therapy for Adolescents, CBT-A and
      Family Based Therapy for Bulimia Nervosa, FBT-BN) for the disorder in comparison with a
      non-specific therapy, Supportive Psychotherapy for Adolescent Bulimia (SPT). Additionally,
      the investigators hope to provide clinicians with information on treatment efficacy,
      variables that might influence outcome, and processes that may affect treatment efficacy that
      will guide them in their efforts to treat adolescent BN.
    

Detailed description: 
      BN is a serious disorder that is characterized by extreme concerns about body weight and
      shape, dieting, and the disinhibited eating behaviors of binging and purging. There are no
      published randomized clinical trials of psychotherapy treatment for Bulimia Nervosa in
      adolescents although it often onsets in this age group. There is evidence that some
      treatments are effective, but none has been empirically tested. Because Bulimia Nervosa is a
      serious medical and psychiatric illness it is important to learn efficacious ways to treat
      this disorder, especially in its early stages. Treatments used in this study are the best
      known treatments for adults with Bulimia Nervosa. The investigators hope to learn which of
      two previously studied treatments might be superior to the other, in an effort to guide
      clinicians in treatment choices. Successfully treating the disorder early on (even in those
      adolescents with partial BN, characterized by binge eating and purging at least one time per
      week over a 6 month period) may reduce the number of cases requiring treatment during
      adulthood, leading to possible reduction in severity of associated psychopathology and lower
      costs, as well as enable individuals to lead more productive lives.

      Given the neglect of adolescent BN in the research literature and the need for information to
      guide the clinical treatment of this disorder, this study's primary aim is to compare the
      efficacy of CBT-A to FBT-BN in decreasing binge eating and purging episodes in adolescents
      with BN and partial BN (defined as binge eating and purging at least one time per week for
      the past six months).

      Participation in this study will last 1 and a half years and will consist of 6 months of
      treatment and a follow-up session at 6 and 12 months post-treatment. All participants will
      first undergo baseline assessments, which include interviews and questionnaires about
      psychological history and BN symptoms, and an Eating Disorder Examination (EDE) interview.
      All treatment assignments consist of 18 sessions of therapy over the course of 6 months.
    

Intervention name(s): Cognitive Behavioral Therapy for Adolescents; Supportive Psychotherapy; Family Based Therapy for Bulimia Nervosa
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): The therapist will work with the adolescent to understand triggers to binge eating and purging, such as thoughts, feelings, and interpersonal difficulties. Also, establishing regular eating patterns and eliminating medically harmful behaviors associated with the eating disorder is a primary goal.; SPT focuses on having the patient build a relationship with the therapist and explore their unique individual needs within the context of their life and the experience of having an eating disorder.; FBT helps parents to take an active role in guiding their child through eating disorder treatment. In this therapy, the parents are supported in helping their child stop bingeing, purging and engaging in other harmful weight-control behaviors. The way in which the eating disorder has impacted the family and the adolescent's development is also explored.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment