Schapman-Williams, Ann M. And Lock, James. (2007). Using cognitive-behavioral therapy to treat adolescent-onset bulimia nervosa: A case study. Clinical Case Studies, 6(6), 508-524.
In an effort to provide a rationale for future large studies, Schapman-Williams and Lock presented a case study of a 16-year-old female Caucasian with bulimia being treated with CBT. The symptoms began 18 months prior to appearing at the clinic, starting with a concern about the need to lose weight. Food restriction and over-exercise was followed by purging through vomiting. Body image distortion and binge eating also developed. By the time she presented at the clinic, the binge-purge cycle was occurring 2-3 times per day. When given a choice between CBT and interpersonal therapy, the patient and parent chose CBT. A standard course of 20 therapy sessions for treating bulimia was prescribed.
By the second therapy session the eating pattern had begun to normalize, a process that was completed by session 12. The binge-purge cycles ended immediately, with only one relapse reported at session 13. Although the patient experienced a slight weight gain between sessions 5 and 6, weight was stable throughout treatment. Self-reports of eating associated distress declined rapidly and was gone by session 9. The study limitations mentioned by the authors included the use of a treatment protocol intended for adults, but the treating therapists were able to adapt by involving the patient's mother, in an effort to make the home environment more conducive to treatment goals. The results of this study suggest that treating adolescent-onset bulimia using CBT for adults is effective.