The main aim of this book is to give people with bulimia nervosa and binge-eating problems the means to help themselves towards recovery. To this end the core of it (Part Two) consists of a self-help manual, which sets out detailed guidelines about what steps need to be taken to restore control to one’s eating. These guidelines are based on extensive research into the most effective means of treating people with bulimia nervosa.
The self-help manual as presented here has gone through many revisions. These have been made on the basis of the experience of myself and my colleagues in helping patients with bulimia nervosa use the manual. A great many of these patients have now done so and gained considerable benefit from it. It is now clear from research into the effectiveness of the manual, that the great majority of people with bulimia nervosa and binge-eating problems could profitably use the principles spelled out in this manual as a guide towards recovery.
It is important to be clear about what ‘recovery’ from bulimia nervosa means. Many people do recover fully. They become able to eat normally without anxiety and without the concerns about their weight and shape which used to dominate their lives. However, many remain vulnerable to difficulties with food and related concerns, even if this vulnerability only becomes evident on rare occasions of stress. The existence of this residual susceptibility does not mean, however, that the person has not recovered. Indeed, a realistic notion of recovery that accepts that difficulties with eating may occasionally recur is both more realistic and more helpful than a rigid definition, and can be a protection against both disappointment and imprudence.
This book is principally intended for people with bulimia nervosa and variations of this disorder. However, it will be of use to some other people as well. The families and friends of people who binge often want to know more about the problem. Part One provides a brief account of the nature of bulimia nervosa and binge-eating problems which will be of use to them, as well as a note on the definition of bulimia nervosa and binge-eating and its relation to other eating disorders. Also, it is helpful to someone who is trying to use this manual if other people in their household are aware of what they are trying to do. By reading the manual, a parent, partner or friend can ensure that they give as much help as possible. Finally, it is suggested in the self-help manual that it is advisable for the person wishing to use it to recruit the assistance of a helper. This could be a friend or relative, but it is preferable if it is someone less closely involved with them, such as a general practitioner, a nurse or a dietitian. Clearly, for such a person to be of most help, they too need to know what advice is contained in the manual.