Appetite‐focused dialectical behavior therapy for the treatment of binge eating with purging: A preliminary trial

Objective: This treatment development study investigated the acceptability and efficacy of a modified version of dialectical behavior therapy (DBT) for bulimia nervosa (BN), entitled appetite focused DBT (DBT‐AF). Method: Thirty‐two women with binge/purge episodes at least one time per week were randomly assigned to 12 weekly sessions of DBT‐AF ( n = 18) or to a 6‐week delayed treatment control ( n = 14). Participants completed the EDE interview and self‐report measures at baseline, 6 weeks, and posttreatment. Results: Treatment attrition was low, and DBT‐AF was rated highly acceptable. At 6 weeks, participants who were receiving DBT‐AF reported significantly fewer BN symptoms than controls. At posttest, 26.9% of the 26 individuals who entered treatment (18 initially assigned and 8 from the delayed treatment control) were abstinent from binge/purge episodes for the past month; 61.5% no longer met full or subthreshold criteria for BN. Participants demonstrated a rapid rate of response to treatment and achieved clinically significant change. Discussion: Results suggest that DBT‐AF warrants further investigation as an alternative to DBT or cognitive behavior therapy for BN. © 2010 by Wiley Periodicals, Inc. (Int J Eat Disord 2011; 44:249–261)