JAMA Netw Open

Therapist-guided internet CBT significantly reduces bulimia symptoms in Japanese women

August 7, 2025

Study details: This multicenter randomized trial enrolled 61 Japanese women (mean age, 27.8 years; mean BMI, 21.1) with DSM-5 bulimia nervosa at 7 university hospitals. Participants were randomized to 12 weeks of therapist-guided, culturally tailored internet-based cognitive behavior therapy (ICBT) plus usual care, or to usual care alone. Primary outcome was the weekly combined frequency of binge eating and compensatory behaviors, assessed by blinded raters at baseline and 12 weeks. Intention-to-treat analysis was performed.

Results: Guided ICBT led to a statistically significant reduction in bulimia nervosa symptom frequency compared with usual care, with an adjusted mean difference of 9.84 episodes per week (95% confidence interval, 2.49–17.18; P = 0.01). Sensitivity analyses confirmed the robustness of the findings. The intervention was well accepted by participants.

Clinical impact: Therapist-guided ICBT, when integrated into usual care, significantly reduces bulimia nervosa symptoms and may improve access to effective treatment for women in settings with limited specialist resources. These findings support the clinical utility of guided ICBT as an accessible, scalable intervention for bulimia nervosa in real-world practice, particularly in East Asian populations.

Source:

Hamatani S; HOPE Project Consortium, et al. (2025, August 1). JAMA Netw Open. Guided Internet-Based Cognitive Behavior Therapy for Women With Bulimia Nervosa: A Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/40762916/