Despite early pessimism regarding its prognosis, behavior therapy has proven to be an effective treatment for bulimia nervosa. The average reduction in vomiting achieved at the end of behavioral treatment is 70%, with about 44% of patients completely abstinent. Even greater improvements are found in studies that use cognitive and behavioral procedures over a longer period and emphasize relapse prevention. Patients treated with behavior therapy also exhibit improvement on measures of psychological symptoms, self-esteem, and social relationships, though the focus of treatment may be on binge eating and vomiting. Nevertheless, a significant minority of individuals drop out of treatment prematurely or remain unimproved. Still in its early stage, behavior therapy for bulimia nervosa needs much more empirical development and evaluation.
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