Psychotherapeutic Approaches in the Treatment of Bulimia Nervosa: A Systematic Review
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Abstract
Bulimia nervosa is an eating disorder characterized by episodes of excessive food intake followed by inappropriate compensatory behaviors. Given its impact on patients’ well-being, there is a need for a comprehensive and up-to-date understanding of the available psychological interventions and their clinical applications. Therefore, this systematic review aimed to describe the main psychotherapeutic approaches used in the treatment of bulimia nervosa, with the purpose of evaluating the available empirical evidence and guiding their application in clinical practice. A search was conducted in academic databases using the PRISMA guidelines, and the methodological quality of the studies was assessed using the CONSORT tool. The included studies were analyzed according to their methodological design, intervention modalities, and outcomes achieved. The findings indicated that Cognitive Behavioral Therapy (CBT) remains the approach with the strongest empirical support. Similarly, Integrative Cognitive-Affective Therapy (ICAT) and Family-Based Therapy for Bulimia Nervosa (FBT-BN) showed promising results in patient profiles with underlying emotional difficulties. Additionally, various delivery modalities were identified, such as individual and group formats, with outcomes varying according to patient characteristics and the treatment context. It was concluded that, while CBT remains the gold-standard treatment, incorporating alternative approaches such as ICAT and tailoring interventions to individual needs could optimize clinical outcomes.
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Antonio Sebastián Perea-Beltrán, Universidad Católica de Cuenca - Ecuador
https://orcid.org/0009-0003-4392-2224
Holds a Bachelor’s degree in Psychology from the University of Cuenca. He completed a Diploma in ADHD and Mood Disorders and a course on Eating Disorders with a psychological and nutritional approach. His academic interests focus on evidence-based clinical interventions.
Geovanny Genaro Reivan-Ortiz, Universidad Católica de Cuenca - Ecuador
https://orcid.org/0000-0003-0643-8022
Clinical psychologist and researcher at the Catholic University of Cuenca. He specializes in the study of eating disorders, cognitive phenotypes, and food intake disorders associated with nutritional patterns.
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