***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE The aims were to test relationships between bulimic eating disorder behaviors , and measures of quality of life , and to replicate previous findings with respect to their prevalence and distribution in a representative sample . METHOD Data were obtained from 3010 interviews of a r and omly selected sample of 4400 adult households .  Quality of life was assessed with the  SF-36 Health Status Measure  and the  Australian Quality of Life Survey .  RESULTS Eating disorder behaviors were associated with significantly lower quality of life scores . On MANOVA , regular current binge eating explained 23 % ( p < 0.001 ) of the variance in SF-36 physical and mental health component scores , and extreme weight control behaviors explained 5 % ( p = 0.001 ) . The main findings of the former South Australian survey were replicated . The mean duration of behaviors since onset was 6.6 ( SD , 9.2 ; median 3 ) years . CONCLUSIONS Eating disorder behaviors were associated with poorer quality of life and were often chronic OBJECTIVE To examine characteristics of individuals who show a rapid and sustained response to cognitive-behavioral therapy ( CBT ) for bulimia nervosa ( BN ) . METHOD As part of a r and omized clinical trial design ed to dismantle CBT for BN , we compared 19 individuals who exhibited complete abstinence from binging and purging after only eight sessions of CBT and maintained abstinence throughout the duration of treatment and the 1-year follow-up interval , to 79 individuals who had a more variable response to treatment . Demographics , baseline clinical characteristics , lifetime comorbidity , and personality disorder symptoms and profiles from the Temperament and Character Inventory were examined . RESULTS In univariate analyses , frequency of binging and purging at baseline , low scores on the Eating Disorders Inventory ( EDI ) Bulimia subscale , lower harm avoidance , and higher self-directedness were associated with rapid response . In multiple regression analyses , frequency of binging at baseline ( OR = 0.87 ; 95 % CI 0.77 - 0.98 ) and self-directedness ( OR = 1.12 ; 95 % CI 1.04 - 1.21 ) independently predicted rapid and sustained treatment response . CONCLUSION Frequency of binging and the character quality of self-directedness may be useful predictors of those individuals who are likely to respond positively to a brief course of CBT for BN A controlled trial comparing family therapy with individual supportive therapy in anorexia nervosa and bulimia nervosa was undertaken . Eighty patients ( 57 with anorexia nervosa ; 23 with bulimia nervosa ) were first admitted to a specialized unit to restore their weight to normal . Before discharge , they were r and omly allocated to family therapy or the control treatment ( individual supportive therapy ) . After one year of psychological treatment , they were reassessed , using body weight , menstrual function , and ratings on the Morgan and Russell scales . Family therapy was found to be more effective than individual therapy in patients whose illness was not chronic and had begun before the age of 19 years . A more tentative finding was the greater value of individual supportive therapy in older patients . To our knowledge , this is the first controlled trial of family therapy in anorexia nervosa and clarifies the specific indications for this treatment The present study sought to evaluate specific hypotheses concerning the relation between cue reactivity and outcome among women with bulimia nervosa . Participants were 135 women aged between 17 and 45 years with a current , primary diagnosis of bulimia nervosa who participated in a r and omized clinical trial evaluating the additive efficacy of exposure and nonexposure-based behavior therapy , to a core of cognitive behavior therapy ( CBT ) . Physiological , self-report , and behavioral measures of cue reactivity to individualized high-risk binge foods were obtained at pretreatment and posttreatment . Primary , secondary , and tertiary outcome measures are reported for posttreatment and six-month follow-up . Self-report measures of cue reactivity at posttreatment were significantly positively associated with symptomatology at posttreatment . Cue reactivity at posttreatment was significantly positively associated with symptomatology at 6-month follow-up . However , cue reactivity at posttreatment did not contribute to the prediction of outcome at follow-up over and above posttreatment outcome . The notion that pretreatment cue reactivity may predict which treatment modality will be most beneficial ( exposure or nonexposure-based treatment ) , as measured by reductions in symptomatology at posttreatment could not be supported . Implication s for future research are discussed Prevalence of bulimia was estimated from a cross-sectional general population survey of 1498 adults , using the Diagnostic Interview Schedule ( DIS ) administered by trained lay interviewers . Lifetime prevalence of the DSM-III syndrome in adults aged 18 - 64 was 1.0 % and this was concentrated in young women : in women aged 18 - 44 lifetime prevalence was 2.6 % , and 1.0 % currently had the disorder . Based on clinicians ' reinterviews of r and om respondents and identified and marginal cases , the prevalence of current disorder using criteria for draft DSM-III-R bulimia was 0.5 % , for DSM-III it was 0.2 % , and for Russell 's Criteria bulimia nervosa 0.0 % . A strong cohort effect was found , with higher lifetime prevalence among younger women , which is consistent with a growing incidence of the disorder among young women in recent years . Although elements of the syndromes were so common as to suggest that dysfunctional attitudes to eating and disturbed behaviour surrounding eating are widespread , there was little evidence of the bulimia syndrome having become an epidemic on the scale suggested by early reports Since the primary role of psychoeducation in eating disorders is to act as a foundation for other interventions , nutritional rehabilitation should use the same therapeutic principles as psychotherapy . This paper looks at the possibility that traditional psychoeducational results can be enhanced in patients with bulimia nervosa by a new nutritional rehabilitation programme focused on psychobiological reorganization of eating behaviour as opposed to the prescription of regular eating patterns . Forty women with purging-type bulimia nervosa were enrolled for a 24-week experimental period of cognitive-behavioural psychotherapy ( CBT ) and were r and omly and evenly divided into two groups to follow a psychobiological nutritional rehabilitation ( PNR ) and a traditional nutritional rehabilitation ( TNR ) programme respectively . The follow-up period averaged 6 months ; four subjects dropped out . The baselines of both groups were comparable with regard to key features , including binge and vomiting frequency , and carbohydrate and lipid intake . Both groups improved significantly over time , though improvements in bingeing and vomiting and lipid intake were greater in the PNR group ( p<0.001 ) , both at the end of the study and at the follow-up . This psychobiological approach to appetite and weight control may constitute a theoretical framework facilitating the application of cognitive-behavioural guidelines to both nutritional rehabilitation and psychotherapy The present study examined the psychopathology associated with binge eating disorder ( BED ) , a new diagnostic category proposed for DSM-IV to classify patients with significant binge eating problems in the absence of purging . Self-report measures of psychopathology ( e.g. , depression , anxiety ) and body image disturbance were administered to 72 women who prospect ively ( 1 ) met criteria for BED ( DSM-IV criteria ) , ( 2 ) reported frequent bingeing but did not meet BED criteria , and ( 3 ) denied problems with eating . Subjects satisfying BED criteria reported higher levels of psychopathology than normals on all measures and sub clinical binge eaters scored between these two groups , but they were closer to subjects without eating problems . The pattern of results was essentially unchanged when corrected for weight . BED subjects and sub clinical binge eaters were less satisfied with their bodies than were normal controls . These findings suggest that BED is not only characterized by frequent bingeing , but more importantly is associated with elevated psychopathology . Overall , these results lend support to the diagnostic criteria proposed for BED Previous research on the treatment of out patients with bulimia nervosa has focused on two treatment strategies : ( 1 ) drug therapy , primarily using tricyclic antidepressants , and ( 2 ) psychotherapy , often employing behavioral and cognitive behavioral techniques . We report here the short-term treatment outcome of a 12-week comparison trial of bulimic out patients who were r and omly assigned to one of four treatment cells : ( 1 ) imipramine hydrochloride treatment , ( 2 ) placebo treatment , ( 3 ) imipramine treatment combined with intensive group psychotherapy , and ( 4 ) placebo treatment combined with intensive group psychotherapy . All three active treatment cells result ed in significant reductions in target-eating behaviors and in a significant improvement in mood relative to placebo treatment . However , the results also suggested that the amount of improvement obtained with the intensive group psychotherapy component was superior to that obtained with antidepressant treatment alone . The addition of antidepressant treatment to the intensive group psychotherapy component did not significantly improve outcome over intensive group psychotherapy combined with placebo treatment in terms of eating behavior , but did result in more improvement in the symptoms of depression and anxiety OBJECTIVE This study examined pretreatment variables to predict outcome in two treatments for bulimia nervosa . METHOD Patients were offered either 16 weeks of cognitive-behavioral therapy ( CBT ) or a self-treatment manual followed by up to 8 weeks of CBT ( sequential group ) . Using complete data , stepwise regression analyses were performed . RESULTS It was found that a longer duration of illness and lower binge frequency predicted a better outcome both at the end of treatment ( p < .001 ) and at 18 months of follow-up ( p < .005 ) . In the sequential group , lower pretreatment binge frequency predicted better outcome at the end of treatment ( p < .05 ) and at 18 months of follow-up ( p < .05 ) . In the CBT group , longer duration of illness predicted better outcome at the end of treatment ( p < .02 ) . DISCUSSION It is concluded that ( 1 ) those with more frequent binging may require a more intense intervention and ( 2 ) those who have been ill longer may be more motivated to respond to treatment Fifteen women with bulimia nervosa were treated with a 4-month course of combined cognitive-behavioral , nutritional and antidepressant therapy ( 5 with amineptine and 10 with fluvoxamine ) . Patients were monitored before and after 1 , 2 and 4 months of therapy for body mass index ( BMI ) , for eating disorder symptoms by the Eating Disorder Inventory ( EDI ) and the Bulimic Investigation Test ( BITE ) , and for depression and anxiety by the Hamilton Rating Scale for Depression and for Anxiety ( HRS-D and -A ) . BITE symptoms and gravity improved significantly and equally in the two groups during the 4 months of therapy . Global EDI scores , depression and anxiety decreased but not significantly . BMI was normal before therapy and did not change during treatment Cognitive behavior therapy was applied to 8 in patients with bulimia ( DSM-III ) .  Improvement of bulimia was superior when compared to 6 bulimics treated with nonspecific psychotherapy .  Social maladjustment was linked to the maintenance of bulimia . The effectiveness of  cognitive behavior therapy  seemed to be impaired by co-morbidity and dysphoric mood . Therefore a more structured externally controlled behavioral hospital treatment program is recommended The purpose of this study was to conduct an assessment of binge eating severity among obese persons . Two question naires were developed . A 16-item Binge Eating Scale was constructed describing both behavioral manifestations ( e.g. , eating large amounts of food ) and feeling/cognitions surrounding a binge episode ( e.g. , guilt , fear of being unable to stop eating ) . An 11-item Cognitive Factors Scale was developed measure two cognitive phenomena thought to be related to binge eating : the tendency to set unrealistic st and ards for a diet ( e.g. , eliminating " favorite foods " ) and low efficacy expectations for sustaining a diet . The results showed that the Binge Eating Scale successfully discriminated among persons judged by trained interviewers to have either no , moderate or severe binge eating problems . Significant correlation between the scales were obtained such that severe bingers tended to set up diets which were unrealistically strict while reporting low efficacy expectations to sustain a diet . The discussion highlighted the differences among obese persons on binge eating severity  and emphasized the role of cognitions in the relapse of self control of eating BACKGROUND Cognitive-behavioral therapy ( CBT ) has documented efficacy for the treatment of  binge eating disorder ( BED ) .  Interpersonal psychotherapy ( IPT ) has been shown to reduce binge eating but its long-term impact and time course on other BED-related symptoms remain largely unknown . This study compares the effects of group CBT and group IPT across BED-related symptoms among overweight individuals with BED . METHODS One hundred sixty-two overweight patients meeting DSM-IV criteria for BED were r and omly assigned to 20 weekly sessions of either group CBT or group IPT . Assessment s of binge eating and associated eating disorder psychopathology , general psychological functioning , and weight occurred before treatment , at posttreatment , and at 4-month intervals up to 12 months following treatment . RESULTS Binge-eating recovery rates were equivalent for CBT and IPT at posttreatment ( 64 [ 79 % ] of 81 vs 59 [ 73 % ] of 81 
    Output:
    
MAIN RESULTS The review supported the efficacy of cognitive-behavioural psychotherapy ( CBT ) and particularly CBT-BN in the treatment of people with bulimia nervosa and also ( but less strongly due to the small number of trials ) related eating disorder syndromes .
CBT was also shown to be effective in group setting s. Other psychotherapies were also efficacious , particularly interpersonal psychotherapy in the longer-term .
Exposure and Response Prevention did not appear to enhance the efficacy of CBT.Psychotherapy alone is unlikely to reduce or change body weight in people with bulimia nervosa or similar eating disorders .