Treating bulimia nervosa in the context of gender dysphoria using 10-session cognitive behavior therapy

Objective: This case report describes the psychological treatment for bulimia nervosa of a 16-year old with co-occurring gender dysphoria. He reported restricting his food intake and purging for approximately 1 year prior to therapy commencing. Method: Ten sessions of cognitive behavioral therapy for eating disorders (CBT-T) were conducted with accommodations for gender-specific body dissatisfaction. Results: The client eliminated binging and purging from the second treatment session and had maintained this at the 3-month follow-up. The quantity and variety of foods he was eating had increased and he no longer reported subjective binges. Improvements were also evident in his depression, anxiety and stress symptoms. Discussion: This suggests that bulimia nervosa may be effectively treated with CBT-T in the context of gender dysphoria. Further research that investigates the generalizability of these outcomes would be beneficial.