Psychological Medicine

A randomized controlled trial of guided imagery in bulimia nervosa

M. J. ESPLEN a1c1, P. E. GARFINKEL a1, M. OLMSTED a1, R. M. GALLOP a1 and S. KENNEDY a1
a1 Department of Psychiatry/Samuel Lunefeld Research Institute, Mount Sinai Hospital; Department of Psychiatry, University of Toronto; Ambulatory Care Program for Eating Disorders, Toronto Hospital; Faculty of Nursing, University of Toronto and Mood Disorders Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada


Background. The objective of this study was to test a guided imagery therapy designed to enhance self-comforting in bulimia nervosa.

Methods. A randomized controlled trial compared 6 weeks of individual guided imagery therapy with a control group. Fifty participants who met DSM-III-R criteria for bulimia nervosa completed the study. Measures of eating disorder symptoms, psychological functioning and the experience of guided imagery therapy were administered.

Results. The guided imagery treatment had substantial effects on the reduction of bingeing and purging episodes; the imagery group had a mean reduction of binges of 74% and of vomiting of 73%. The imagery treatment also demonstrated improvement on measures of attitudes concerning eating, dieting and body weight in comparison to the control group. In addition, the guided imagery demonstrated improvement on psychological measures of aloneness and the ability for self-comforting.

Conclusions. Evidence from this study suggests that guided imagery was an effective treatment for bulimia nervosa, at least in the short-term.

c1 Address for correspondence: Dr M. J. Esplen, Suite 915, Department of Psychiatry, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario, M5G IX5, Canada.