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"After the first treatment course, I never really lost control again, despite taking 5 more years to finish treatment." Single woman in mid-30s with some bingeing and purging, and anorexia at times. There is some controversy about the use of the term "cure" for bulimia nervosa. Some clinicians prefer the terms "remission" and "recovery" because the risk factors for the behavior are often still present and relapse can occur. Nonetheless, treatment for bulimia nervosa can reduce and even halt binge eating and purging/non-purging behavior in many patients. The amount and type of treatment required to achieve a successful long-term outcome and the chances of relapse vary widely among individuals. Also, the definitions that different clinicians use to define remission may vary, and these variations affect the reported rates of remission, according researchers from the University of Toronto in Canada who recently studied the impact of different definitions on reported relapse rates. They proposed using standard definitions for partial and full relapses: partial relapse would be 2 symptom episodes per month for 2 months (which by DSM-IV standards would be considered a diagnosis of ED-NOS); full relapse would be defined as meeting the full DSM-IV diagnostic criteria for the disorder. Thus, from this definition, the implied definition of remission is less than 2 episodes per month. The published scientific data on remission rates is scarce, since few long-term studies have been done on patients who have received treatment for bulimia nervosa. The available data from several studies shows that about 52%-74% of patients who received treatment for bulimia nervosa and achieved a remission were in remission five years later. For shorter time periods, the remission rates reported in published studies varied more widely. Some clinicians have reported anecdotally that self-recovery is possible, although little scientific evidence from well-conducted studies is available to really indicate the effectiveness of self-recovery. What are the positive and negative indications for recovery?Researchers have identified some indicators that may predict chances for a successful recovery. Individuals who are self-confident, realistic, goal-oriented, and make early progress in therapy usually respond well to the overall treatment plan. Individuals who begin treatment with a low body mass index, have a history of obesity, and show signs of depression may not respond well to therapy.Bulimia nervosa may also evolve into "eating disorder not-otherwise specified" (ED-NOS) if the symptoms occur infrequently after treatment and only some of the criteria for bulimia nervosa are met. Few people with bulimia nervosa develop anorexia, although this does occur. A slang term for this condition is "bulimarexia." |
Copyright 2010 ECRI Institute