UND researcher hails new bulimia treatment

A team led by UND researcher Stephen Wonderlich has developed a new, successful therapy for the eating disorder bulimia nervosa, the university said in a news release.

The treatment is psychological in nature and focuses on the connection between emotions and the binge eating characteristic of bulimia, according to Wonderlich

Emotional processes — feeling badly — are very important in triggering bulimic behaviors, he said. People engage in the bulimic behaviors because they feel better momentarily.

The treatment was developed over more than a decade with 80 patients treated in a randomized, controlled trial at Fargo’s Neuropsychiatric Research Institute, a nonprofit group with close ties to UND, and at the University of Minnesota in Minneapolis.

The patients used personal digital assistants such as the Palm Pilot and, later, cell phones to document their feelings and behaviors.

“Basically, we’re asking patients to report how they feel and observe the increase in negative emotions leading up to the behavior,” Wonderlich said in the release. “What we want to know is what are things that make people feel badly, and then help them recognize that, and change their responses to those negative emotions.”

He is a Chester Fritz distinguished professor of neuroscience at UND and director of clinical research at NRI.

Effectiveness

The new treatment fared well when compared to an established treatment developed by Chris Fairburn of Oxford University — the most scientifically-supported treatment available for adults with bulimia, according to Wonderlich.

While the Oxford treatment focuses on the bulimic person’s overvaluing of body shape and weight as well as dietary restrictions, the NRI treatment focuses on eating behavior, emotional variables and relationship variables, he said.

“When we did the scientific comparison, there was no difference between our treatment and the established treatment in terms of outcomes — they were comparable, or equal, in their efficacy,” he said. “This is good news for the field because now there is another promising alternative treatment available, which is a little different in nature than the Oxford treatment.”

He also noted that his treatment had one of the lowest dropout rates in a scientific trial with bulimic patients. “In other words, just about everyone who started the trial completed the treatment.”

Bulimia is characterized by binge eating followed by purging, such as inducing vomiting or consuming laxatives. These behaviors may be followed by prolonged bouts of fasting, even though the person afflicted may be of normal weight.

The term bulimia comes from a Greek word meaning “ravenous hunger,” although the extent to which hunger actually motivates binge eating is unclear. The disease was first described by the British psychiatrist Gerald Russell in 1979.

Bulimia is slightly different than anorexia nervosa, an eating disorder characterized by self-starvation, intense fear of fat and gaining weight and body image disturbances. Patients who suffer from these disorders have high rates of other psychiatric problems including major depression, anxiety disorders, substance use and personality disorders, according to Wonderlich.

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