Intensive Nutritional Counselling in Bulimia Nervosa: A Role for Supplementation with Fluoxetine?

Objective: The aims of the paper are to determine whether nutritional counselling is associated with an improvement in bulimic symptomatology, whether this improvement is maintained during post-treatment follow-up, and whether the addition of fluoxetine 3 × 20 mg/day confers additional benefit. Method: Psychological, pharmacological and combined psychopharmacological treatments of bulimia nervosa were reviewed briefly. Sixty-seven patients referred to specialist eating disorder services who fulfilled strict diagnostic criteria were treated with intensive nutritional counselling and randomly assigned to either fluoxetine 3×20 mg/day or placebo. After a 1-week ‘wash-out’, active treatment was given over 8 weeks, followed by post-treatment interviews at 12 and 20 weeks. Results: Both groups of patients improved significantly during treatment. In some respects, the fluoxetine group did slightly better as demonstrated by the items ‘restraint’, ‘weight concern’ and ‘shape concern’ (p