Compliance with a self‐care manual in guided self‐change for bulimia nervosa

Objective: To investigate the effect of compliance and its predictors on outcome. Method: Sixty‐two patients with DSM‐III‐R bulimia nervosa (BN) were randomly assigned to a self‐care manual plus eight fortnightly sessions of guided self‐change or 16 sessions of weekly cognitive behavioral therapy. Results: At the end of treatment, the group of high compliers had not achieved higher abstinence rates than low compliers regarding BN symptoms. At follow‐up on average 43 weeks (SD = 26 weeks) after the end of therapy, those who had completed more exercises were more likely than low compliers to be abstinent from bingeing and vomiting. Those with a high frequency of vomiting at the beginning of therapy were less likely to use the manual while those with a longer duration of illness and higher levels of restraint were more likely to use the manual. Discussion: Exercises seem to be particularly important. Copyright © 2001 John Wiley & Sons, Ltd and Eating Disorders Association.