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Cognitive Behavioral Model of Bulimia Nervosa
A licensed copy of Fairburn and colleagues (2003) cognitive behavioral model of bulimia nervosa (BN) which describes a framework to address key components of BN.
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Overview
Bulimia nervosa is characterized by episodes of binge eating accompanied by compensatory behaviors like self-induced vomiting or excessive exercise to prevent weight gain. Fairburn, Cooper, and Shafran developed a cognitive-behavioral model illustrating how these behaviors stem from an over-evaluation of eating, shape, and weight control as primary measures of self-worth (Fairburn, Cooper, & Shafran, 2003).
Why Use This Resource?
Understanding the key underpinnings of bulimia nervosa (BN) is important for effective intervention. This resource helps clinicians to:
- Understand the maintenance mechanisms of BN.
- Explain key aspects of BN, such as strict dieting and use of compensatory behaviors (e.g., purging).
- Develop appropriate case formulation for clients struggling with BN.
Key Benefits
Insight
Deepens understanding of how BN is maintained.
Education
Acts as an informative client handout.
Discussion
Promotes exploration of key factors in BN.
Learning
Supports clinician knowledge and supervision.
Who is this for?
Bulimia Nervosa
Designed to help individuals affected by bulimia nervosa (BN).
Integrating it into your practice
01
Learn
Understand more about the cognitive behavioral model of bulimia nervosa (BN).
02
Organize
Use the model as a template to organize your case formulations.
03
Educate
Use your knowledge of the model to explain maintenance processes to clients.
04
Discuss
Engage clients in discussions about their beliefs and behaviors.
05
Tailor
Customize interventions based on individual maintenance mechanisms.
06
Reflect
Use in supervision to discuss case conceptualizations and treatment plans.
Theoretical Background & Therapist Guidance
Fairburn, Marcus and Wilson (1993) proposed that a dysfunctional system for evaluating self-worth is primary to the maintenance of bulimia nervosa. Instead of evaluating one’s self-worth based on a broad range of criteria they argue that people with bulimia judge themselves largely, or even exclusively, in terms of their eating habits, shape, or weight (and often all three) and their ability to control them. The ‘problems’ of bulimia nervosa, such as weight-control behavior and preoccupation with weight, are seen as resulting from this primary mechanism.
In the extended 2003 theory a number of additional maintenance mechanisms were added to the model. It was proposed that these only operate in some patients, and include clinical perfectionism, core low self-esteem (persistent and pervasive negative self-beliefs that are viewed as part of the individual’s self-identity), mood intolerance (difficulty coping with strong mood states), and interpersonal difficulties.
Fairburn, Cooper and Shafran (2003) proposed a transdiagnostic model of eating disorder, of which this model of bulimia forms a part. One interesting characteristic of the treatment is that The patient’s specific eating disorder diagnosis is not of relevance to the treatment. Rather, its content is dictated by the particular psychological features present and the processes that appear to be maintaining them.
What's inside
- A graphical depiction of the model.
- Insights into key maintenance mechanisms.
- Guidelines for using the resource with clients.
FAQs
BN is a serious eating disorder characterized by recurrent episodes of binge eating followed by compensatory behaviors such as vomiting, fasting, or excessive exercise to prevent weight gain.
The model explains how overvalued beliefs (about shape, weight, and eating), strict dieting, and use of compensatory behaviors maintain binge-eating.
Clinicians use it to guide their case formulation, helping them to effectively target their interventions.
How This Resource Improves Clinical Outcomes
By applying the model, therapists and clients benefit from:
- Targeted interventions focusing on key maintenance mechanisms.
- Enhanced client engagement through increased understanding of their difficulties.
- Improved treatment outcomes by addressing core psychological features.
Clinicians Who Use This Resource Also Use
References And Further Reading
- Fairburn, C. G., Cooper, Z., Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: a “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41, 509-528.
- Fairburn, C. G., Marcus, M. D., & Wilson, G. T. (1993). Cognitive-behavioral therapy for binge eating and bulimia nervosa: a comprehensive treatment manual. In C. G. Fairburn, & G. T. Wilson (Eds.), Binge eating: nature, assessment and treatment (pp. 361–404). New York: Guilford Press.
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