Dr Virginia McIntosh
“A therapist might spend time with a woman in the scenario where she usually binges... We simulate the situation as best as possible.”
People with a fear of flying are often treated by, first, talking about planes, watching them and, ultimately, getting aboard one.
The same principal of exposing bulimic patients to their particular fraught situations has been successfully trialled by a group of ingenious University of Otago, Christchurch, researchers.
The research team, including clinical psychologist Dr Virginia McIntosh, investigated whether giving exposure therapy – where patients and therapists re-enact scenarios that typically precede binging and purging – helped them abstain from these behaviours.
After five years, about half of patients who had undergone exposure therapy were no longer binging and purging. Of the group who did not receive exposure therapy, 27 per cent were no longer binging and purging five years after treatment.
The Christchurch study followed 135 women for five years after therapy. All women were given cognitive behavioural therapy – the psychotherapy with the greatest success rate in treating bulimia nervosa. Two thirds of women also received one of two forms of exposure therapy treatment. A final third received relaxation therapy.
McIntosh says before binging and purging women's anxiety levels tend to rise dramatically. Exposure therapy puts women in challenging situations until their anxiety and urges to binge or purge gradually reduce.
“A therapist might spend time with a woman in the scenario where she usually binges. So we'd be there with the foods she commonly binges on, in tracksuit pants at home and talk about the hard day she's had. We simulate the situation as best as possible.
“We might also be with the woman while she eats these binge foods and go through the things she does after a binge and before purging,'' McIntosh says.
Bulimia nervosa is a debilitating and physically damaging disease. Clinicians the world over are looking for ways to maximise treatments – and the work of McIntosh and her team gives evidence of another tool.
Exposure therapy is a very time-consuming treatment, says McIntosh, because therapists stay with patients until their anxiety subsides. However, the Christchurch team's positive findings show that it is a possible treatment for those who do not respond to common treatments for bulimia.
Funding
- Health Research Council
- Lottery Health Research