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Research on Social Work Practice
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Social Work Practice with a Bulimic Population: A Comparative Evaluation of Purgers and Nonpurgers

Ronna I. Saunders

Center for Behavioral Change, Richmond, VA

David N. Saunders

Virginia Commonwealth University

The traditional definition of bulimia has focused on persons who engage in purging behavior. Limited research has been conducted on bulimics, either obese or non-obese, who do not purge. These nonpurging bulimics are often frustrated in their attempts to obtain treatment because their condition is not sufficiently serious to warrant treatment. Because the incidence of bulimia in the general population is high, social workers are likely to see clients who are struggling with this problem. This study compared groups of purging and nonpurging bulimics who had received cognitive-behavioral treatment in a social work practice. It measured change on a number of dimensions related to eating behaviors, feelings, and life functioning. The study found few, if any, significant differences between purging and nonpurging bulimics 2 to 5 years following treatment. Although all groups showed significant improvement at follow-up, some bulimic symptoms remained. In addition, the disordered eating patterns of obese and non-obese bulimics were similar across weight categories. The results suggest that out-of-control eating behavior, not purging, may be the key distinguishing feature of bulimia and that greater attention must be directed at relapse prevention and aftercare once treatment has been completed.

Research on Social Work Practice, Vol. 3, No. 2, 123-136 (1993)
DOI: 10.1177/104973159300300201
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