Behavioural and Cognitive Psychotherapy

Research Article

Investigating the Use of CD-Rom CBT for Bulimia Nervosa and Binge Eating Disorder in an NHS Adult Outpatient Eating Disorders Service

Lisa Grahama1 c1 and Mark Waltona1

a1 Lancashire Care NHS Foundation Trust, Chorley, UK


Background: Many patients who experience bulimia nervosa (BN) and binge eating disorder (BED) find it hard to access evidence-based treatments. Rates of failure to enter outpatient services following initial assessment are high, as are dropout rates from specialist outpatient eating disorders services. Aims: To offer CD-Rom CBT, a cognitive-behavioural multi-media supported self-help treatment, in a locality-based outpatient NHS Eating Disorders Service to patients who have binge eating disorder and bulimia nervosa. Method: Patients referred to a catchment-based NHS outpatient eating disorders service who were assessed and had an eating disorder with a binge-eating component were offered CD-Rom based CBT (Overcoming Bulimia) whilst on the waiting list for individual CBT. Results: Forty patients completed the 8 sessions and attended the evaluation appointment (13 had BN, 27 had BED). For both groups, there were significant improvements in well-being and functioning, as well as significant reductions in problems and risk. There was also a significant reduction on the “Bulimic Subscale” of the EDI. These results were comparable with the original study findings (Schmidt, Treasure and Williams, 2001). Dropouts from the CD-Rom reflected rates common to other EDS treatments suggesting that CD-Rom did not directly impact upon service dropout rates. Conclusions: Computer assisted CBT for Eating Disorders offers a promising, feasible and acceptable first step for patients who have bulimia nervosa or binge eating disorder and access treatment from specialist eating disorders services.

(Online publication January 05 2011)


c1 Reprint requests to Lisa Graham, East Lancashire Eating Disorders Service, Eating Disorders Managed Clinical Network, Lancashire Care NHS Foundation Trust, NHS Eating Disorders Service, 18 Euxton Lane, Chorley PR71PS, UK. E-mail: