ABSTRACT
The great majority of people with bulimia nervosa and related disorders do not seek treatment; and those who do present for treatment in specialist outpatient clinics therefore represent a highly selected group (Whitaker et al., 1990; Fairburn et al., 1996). The reason for this is at least partly because the shame people feel about having the disorder prevents them from being open about their difficulties. However, it is also the case that specialist services are not widely available and people will therefore not have access to the services they need. There are therefore two priorities for those concerned with providing therapeutic services to people with bulimia nervosa. The first is to be in a position to deliver evidence-based effective treatments to the cases that present for treatment. The second is to find an effective means of providing therapeutic help to those people who, for one reason or another, do not present to specialist clinics but nevertheless have the disorder and are distressed and disabled by it.
