Section - Video Lectures

03. Key Considerations When Prescribing for Bulimia Nervosa

Published on April 1, 2025 Certification expiration date: April 1, 2028

Scott Crow, M.D.

Adjunct Professor of Psychiatry - University of Minnesota

Key Points

Consider medication when patients prefer it over psychotherapy or when they have partially responded to psychotherapy but symptoms persist.
Medication use for comorbid conditions like depression and anxiety should follow standard protocols but consider higher dosing.
Antidepressants for bulimia nervosa directly treat eating disorder symptoms, not just comorbid depression.

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Slides and Transcript

Slide 1 of 8

So now, I’d like to spend a little bit of time talking about key things to think about when you’re considering medication prescribing for someone with bulimia nervosa. It really comes down to when does it make sense to try medications.

Key Considerations When Prescribing for Bulimia Nervosa Slide 1 of 8

Slide 2 of 8

The first is that it is not infrequently the preferred treatment approach for patients. We offer psychotherapy very frequently and many people would prefer that to medications but there also is a group that really would prefer medications to psychotherapy. And in the treatment of bulimia nervosa, that’s a reasonable thing to consider because I mentioned before that the response rates for psychotherapy were higher and that’s true but the response rates for medication are still significant and still certainly strong enough to make them a very reasonable choice.

References:

Crone, C., Fochtmann, L. J., Attia, E., Boland, R., Escobar, J., Fornari, V., Golden, N., Guarda, A., Jackson-Triche, M., Manzo, L., Mascolo, M., Pierce, K., Riddle, M., Seritan, A., Uniacke, B., Zucker, N., Yager, J., Craig, T. J., Hong, S. H., … Medicus, J. (2023). The American Psychiatric Association Practice Guideline for the Treatment of Patients With Eating Disorders. American Journal of Psychiatry, 180(2), 167-171. https://doi.org/10.1176/appi.ajp.23180001
Rodan, S.-C., Bryant, E., Le, A., Maloney, D., Touyz, S., McGregor, I. S., Maguire, S., & National Eating Disorder Research Consortium. (2023). Pharmacotherapy, alternative and adjunctive therapies for eating disorders: findings from a rapid review. Journal of Eating Disorders, 11, Article 112. https://doi.org/10.1186/s40337-023-00814-y

Key Considerations When Prescribing for Bulimia Nervosa Slide 2 of 8

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04. The Role of Pharmacotherapy in Anorexia Nervosa

Learning Objectives:

After completing this activity, the learner will be able to:

Identify appropriate situations for medication use in eating disorders.
Select appropriate first-line pharmacotherapy for bulimia nervosa.
Apply evidence-based medication strategies for different eating disorder types.

Original Release Date: April 1, 2025

Expiration Date: April 1, 2028

Expert: Scott Crow, M.D.

Medical Editor: Flavio Guzmán, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

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Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.75 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.