Specialized treatment for eating disorders is expensive and can be hard to find. The good news: if you have bulimia nervosa, binge eating disorder, or subclinical versions of either of these, self-help may bridge the gap. Research shows self-help can be beneficial. Through the use of a manual, workbook, or smartphone or web-based platform, you can work through a series of steps to learn about your problem and develop skills to overcome and manage the disorder. Self-help, however, is not recommended for anorexia nervosa given the special medical needs of patients with this disorder.
Not all self-help is equally effective. The enhanced version of cognitive behavioral therapy (CBT-E) is the most effective treatment for individuals with bulimia and binge eating disorder; outcome studies show that approximately 65% of people recover after 20 sessions of psychotherapy. Self-help approaches based on CBT have been the most studied.
Pure Self-Help and Guided Self-Help
In pure self-help, the patient works through the material entirely independent of the guidance of a professional. In contrast, guided self-help consists of self-help plus the support of another person or facilitator who may not be a professional eating disorder therapist. This support person can be, for example, a lay person or recovered person; support can be delivered in a variety of formats, such as in-person, over the phone, by text message, or over the internet. The frequency of support can vary but is usually less intensive than weekly psychotherapy.
Pure self-help and guided self-help for eating disorders have proven effective for subsets of individuals with bulimia nervosa, binge eating disorder, and OSFED (Other Specified Feeding & Eating Disorder). Of these, there is the most support for its use among individuals with binge eating disorder. There is more support for guided self-help than pure self-help. Self-help has also been shown to be superior to no treatment.
In 2013, Rutgers University’s Counseling Center began routinely offering guided self-help for eating disorders after a graduate student’s research proved this was a feasible and effective model. In a two-year study Zandberg, the student trained a group of seven graduate psychology students who in turn provided guided self-help treatment to 38 students diagnosed with either bulimia nervosa or binge eating disorder. The support, which was based on cognitive behavioral therapy principles, was offered in ten 25-minute sessions. At the end of the 12-week program, 42 percent of the subjects experienced no binge episodes and 63 percent no longer met criteria for an eating disorder.