What is recognized as the first-line treatment for bulimia nervosa?

The first-line treatment for bulimia nervosa is a combination of Cognitive Behavioral Therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs). CBT is particularly effective in addressing the cognitive distortions and behavioral patterns characteristic of bulimia. It focuses on identifying and changing unhealthy thoughts and behaviors related to eating, body image, and weight. Through structured sessions, patients learn coping strategies, explore triggers for binge eating, and develop healthier attitudes toward food and body image.

SSRIs, particularly fluoxetine, have been shown to help reduce binge-eating and purging behaviors, as well as to alleviate associated symptoms such as depression and anxiety that often co-occur with bulimia nervosa. The dual approach of combining therapy with medication can enhance treatment efficacy by targeting both the psychological and biological aspects of the disorder.

While other therapeutic options, such as Acceptance and Commitment Therapy (ACT), dynamic psychotherapy, and supportive therapy can provide benefits, they do not have the same level of empirical support specifically for bulimia nervosa as CBT and SSRIs. Thus, the combination of CBT and SSRIs is the most robustly supported and recognized first-line treatment for this condition.