Preface

Bulimia nervosa and eating disorders are a common cause of distress and health related burden for young women and men. First described over three decades ago by Russell as an "ominous variant of anorexia nervosa" and Boskind-Lodahl and colleagues as "bulimarexia", there have since then, been rapid advances in treatment and understanding of bulimia nervosa phenomenology and determinants. The early terminology reflected the origin of the diagnosis in the context of anorexia nervosa, the first eating disorder to be delineated. Since then links with other problems of binge eating have been clarified and specific psychotherapies trialled and are now in widespread use. However, for many patients treatment comes late in the course of the illness and may incompletely address complex psychopathology and co-morbidities. The present book thus brings timely and contemporary understandings of the illness to aid in current thinking regarding prevention and treatment.

The first chapter describes interpersonal therapy for bulimia nervosa. It is based on interpersonal therapy for depression and used as a control therapy for specific psychotherapy in bulimia. However, the relationship of bulimia nervosa symptoms to interpersonal function are specifically now addressed. Medical and physical aspects of the illness are reviewed in a chapter by Francavilla et al. and the role of exercise in maintenance of illness in a chapter by Bratland-Sanda et al. and other new approaches by Torres-McGehee et al.

How to help people earlier access therapy is discussed in a chapter describing two randomized controlled trials of targeted prevention for bulimia nervosa based around adaptations of health literacy and self-help that can be applied in community and primary care settings. Guidance for early detection is also provided in a chapter on practical screening methods. Eating disorders arise in adolescence and early adult years and a book would be incomplete without attention to this. This book is no exception and a fresh look at adolescents and body dissatisfaction is found in the chapter by Souza-Kaneshima et al.

Mood disorders are one of the most important co-morbidities and Mario et al. review and discuss the role of depressive features in the maintenance of bulimia nervosa. Further maintaining and predisposing features are discussed in chapters on personality and coping by Tomaz et al. and a comprehensive review of by Ignacio et

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al. Untested approaches that may address intra and inter personal deficits using psychodrama and object relations and further dynamic understanding are discussed over two chapters by Izydorczyk et al.

This book will be read by therapists interested in enhancing their current approaches and those interested in earlier and more effective prevention and closing the gap between illness onset and accessing treatment. They will find practical guidance but also new ideas and ways of thinking about the bulimia nervosa and the illness experience in this book.

> **Phillipa Hay**  University of Western Sydney, Australia

X Preface

over two chapters by Izydorczyk et al.

experience in this book.

al. Untested approaches that may address intra and inter personal deficits using psychodrama and object relations and further dynamic understanding are discussed

This book will be read by therapists interested in enhancing their current approaches and those interested in earlier and more effective prevention and closing the gap between illness onset and accessing treatment. They will find practical guidance but also new ideas and ways of thinking about the bulimia nervosa and the illness

**Phillipa Hay** 

Australia

University of Western Sydney,

**Part 1** 

**Developments in Treatment** 
