Highlights
– A 12-week therapist-guided internet-based cognitive behavioral therapy (ICBT) program tailored to Japanese culture significantly reduced weekly combined frequency of binge eating and compensatory behaviors compared with usual care (adjusted mean difference 9.84 episodes; 95% CI, 2.49–17.18; P = .01; Cohen d = 0.73).
– Trial enrolled 61 women with DSM-5 bulimia nervosa across seven university hospitals in Japan; primary endpoint assessed by blinded independent raters at 12 weeks.
– Findings support ICBT as an accessible, clinically effective adjunct to usual care for women with bulimia nervosa in East Asian clinical settings, though generalizability beyond the trial population and long-term durability require further study.
