new insights into the prevention and treatment of bulimia nervosa

Preface
Bulimia nervosa and eating disorders are a common cause of distress and health
related burden for young women and men. First described over three decades ago by
Russell as an “ominous variant of anorexia nervosa” and Boskind-Lodahl and
colleagues as ”bulimarexia”, there have since then, been rapid advances in treatment
and understanding of bulimia nervosa phenomenology and determinants. The early
terminology reflected the origin of the diagnosis in the context of anorexia nervosa, the
first eating disorder to be delineated. Since then links with other problems of binge
eating have been clarified and specific psychotherapies trialled and are now in
widespread use. However, for many patients treatment comes late in the course of the
illness and may incompletely address complex psychopathology and co-morbidities.
The present book thus brings timely and contemporary understandings of the illness
to aid in current thinking regarding prevention and treatment.
The first chapter describes interpersonal therapy for bulimia nervosa. It is based on
interpersonal therapy for depression and used as a control therapy for specific
psychotherapy in bulimia. However, the relationship of bulimia nervosa symptoms to
interpersonal function are specifically now addressed. Medical and physical aspects of
the illness are reviewed in a chapter by Francavilla et al. and the role of exercise in
maintenance of illness in a chapter by Bratland-Sanda et al. and other new approaches
by Torres-McGehee et al.
How to help people earlier access therapy is discussed in a chapter describing two
randomized controlled trials of targeted prevention for bulimia nervosa based around
adaptations of health literacy and self-help that can be applied in community and
primary care settings. Guidance for early detection is also provided in a chapter on
practical screening methods. Eating disorders arise in adolescence and early adult
years and a book would be incomplete without attention to this. This book is no
exception and a fresh look at adolescents and body dissatisfaction is found in the
chapter by Souza-Kaneshima et al.
Mood disorders are one of the most important co-morbidities and Mario et al. review
and discuss the role of depressive features in the maintenance of bulimia nervosa.
Further maintaining and predisposing features are discussed in chapters on
personality and coping by Tomaz et al. and a comprehensive review of by Ignacio et