Bulimia Nervosa — MRCPsych Paper B MCQ

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ModerateEating DisordersBulimia NervosaMRCPsych Paper B

A 22-year-old woman with bulimia nervosa presents to a specialist eating-disorder service. She is medically stable and has not previously received psychological treatment for the disorder. According to NICE NG69, which psychological treatment should be considered first?

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Correct answer: A — Bulimia-nervosa-focused guided self-help

The correct answer is A. NICE recommends considering bulimia-nervosa-focused guided self-help as the initial psychological intervention for adults with bulimia nervosa. It should use cognitive-behavioural self-help materials supplemented by brief supportive sessions. If this approach is unacceptable, contraindicated or ineffective after 4 weeks, individual eating-disorder-focused CBT (CBT-ED) should then be considered; this typically comprises up to 20 sessions over 20 weeks. Bulimia-nervosa-focused family therapy is recommended primarily for children and young people, not as the initial adult treatment. Focal psychodynamic therapy, interpersonal psychotherapy and dialectical behaviour therapy are not recommended by NG69 as first-step psychological treatments for adults with bulimia nervosa.

Reference: National Institute for Health and Care Excellence. Eating disorders: recognition and treatment (NG69), section 1.5, recommendations 1.5.2–1.5.5. 2017, updated 2020. https://www.nice.org.uk/guidance/ng69/chapter/recommendations#treating-bulimia-nervosa