The New Face of Bulimia Nervosa

Researchers have generally believed bulimia nervosa affects predominantly white, affluent women. However, a recent study indicates this may not, in fact, be the case. Bulimia nervosa, may rather affect mostly black woman and those with lower incomes.

USC economist Michelle Goeree as well as fellow economists John Ham from the University of Maryland and Daniela Iorio from the Universitat de Autonoma in Barcelona Spain conducted a 10-year survey with more than 2,300 girls in schools in California, Washington, D.C., and Ohio to determine who really is affected by bulimia. Starting at age 9 or 10 years old the participants were surveyed every year regarding their eating habits as well as psychological characteristics that often accompany bulimia, such as depression and body image.

The results showed that black girls were 50% more likely to suffer from bulimic behavior, including binging and purging, than white girls. More specifically, while 1.7% of white girls were clinically bulimic, 2.6% of black girls were clinically bulimic. Overall, approximately 2.2% of all girls who were surveyed were clinically bulimic, which is close to the national average. Black girls also scored higher on a commonly used index to gage the severity of bulimia.

Bulimia was present among 1.5% of girls who had at least one parent with a college education. However, 3.3% of girls with parents with a high school diploma or less suffered from bulimia.

Finally, girls who had the lowest incomes were significantly more likely to suffer from bulimia than those in the highest income brackets.

The researchers assert that most studies of bulimia get their data from hospitals. Those who are able to be treated in a hospital are most often those who have good insurance and/or can pay out of pocket for eating disorder treatment. Those who have low income or who do not have a lot of education may not have insurance or may not be able to afford eating disorder treatment.

The researchers argue that bulimia may be better off classified as an addiction, given the presence of bulimia among lower income and less educated individuals. This way, they argue, more federal, state, and local treatment programs can be created for bulimia and the out-of-pocket costs to families can be reduced.

Source:

Psych Central: Black Girls At Risk for Bulimia

"Enhanced" Cognitive-Behavioral Therapy for Individuals with Eating Disorders

A new study in the United Kingdom shows a new variation on Cognitive-Behavioral Therapy may be effective in treating a majority of individuals with eating disorders.

Eating disorders in the UK are classified somewhat differently than they are in the United States. Mainly, they classify eating disorders as Anorexia Nervosa, Bulimia Nervosa, and "atypical" eating disorders, which is the United States' equivalent to Eating Disorder Not Otherwise Specified. "Atypical" eating disorders in the UK are defined as having both features of anorexia and bulimia, such as self-starvation, binge-eating, making oneself throw up purposefully, taking laxatives, and exercising excessively.

The new "enhanced" Cognitive-Behavioral Therapy was developed from the previous form of cognitive-behavioral therapy, which was specifically designed for individuals suffering from bulimia nervosa by Professor Christopher Fairburn, who is a Wellcome Trust Principal Research Fellow at the University of Oxford. He also developed the new "enhanced" Cognitive-Behavioral Therapy, intended to help even more individuals suffering from eating disorders.

Fairburn and his colleagues conducted a study with 154 individuals suffering from eating disorders. Two types of enhanced Cognitive-Behavioral Therapy (CBT-E) were developed, a simple version and a more complex version. The simple version focused on the primary issue of the eating disorder while the more complex version of CBT-E focused on the eating disorder as well as other features that are commonly associated with eating disorders, such as depression, self-esteem, and perfectionism.

Each individual participating in the study received 20 50-minute sessions of simple or complex CBT-E over the span of 20 weeks.

The researchers discovered that participants responded well to both types of CBT-E and that these improvements held over a one-year period, the time in which relapse into an eating disorder is most common. More specifically, of the participants who completed treatment, two-thirds made a full recovery from their eating disorders. Although one-third of participants relapsed into their eating disorders, they maintained significant improvement.

This study seems to indicate that CBT-E is an effective treatment for a majority of individuals who are suffering from eating disorders. Fairburn and his colleagues are also conducting a large study in order to measure the effectiveness of CBT-E on individuals suffering from anorexia, specifically.

Source:
Psych Central: Behavioral Therapy for Eating Disorders