ABSTRACT
In our Western industrial culture, where food is plentiful, it is ironic that self-starvation and a pattern of bingeing and purging are major problems, particularly for young women. These two eating disorders – bulimia and anorexia nervosa – are addressed in this chapter. First, a case study illustrating the central clinical features of bulimia and an account of a client’s progress through a psychological treatment programme is given. This is followed by a succinct account of the clinical features, epidemiology, course and aetiology of bulimia and anorexia. The use of motivational interviewing to engage clients with eating disorders in assessment and treatment is then outlined. An account is given of the assessment of eating disorders along with detailed guidelines for the evidence-based treatment of bulimia with cognitivebehaviour therapy (CBT) and interpersonal therapy (IPT). Two biomedical interventions are also mentioned: inpatient weight restoration programmes for emaciated clients with anorexia and the use of antidepressants in the treatment of bulimia.
