Bulimia nervosa is a serious eating disorder marked by recurring cycles of binge eating followed by compensatory behaviors such as self-induced vomiting, laxative use, or excessive exercise. It affects primarily young women but occurs across genders and age groups, and the secrecy surrounding the illness often delays diagnosis by years. Medical complications include electrolyte imbalances, dental erosion, and cardiac arrhythmias.
What's actually going on in research
Cognitive behavioral therapy (CBT) delivered in person or online is the most effective treatment, achieving remission in roughly one-third to one-half of patients who complete a full course. Fluoxetine is the only FDA-approved medication for bulimia nervosa. Research is exploring enhanced CBT variants, integrated emotion regulation therapies, and gut-brain axis interventions including GLP-1 receptor agonists for their potential effects on binge-purge cycles and the neurobiological urge to binge.
Enhanced CBT variants
Therapist-delivered and internet-based enhanced CBT programs are in trials comparing different delivery formats, session frequencies, and adjunctive modules targeting emotion regulation and perfectionism.
GLP-1 receptor agonists
Semaglutide and related GLP-1 agonists are in early trials for bulimia nervosa given their known effects on appetite regulation, reward processing, and compulsive eating behavior.
Neuromodulation approaches
Transcranial magnetic stimulation targeting prefrontal circuits involved in impulse control is being studied as an add-on to CBT for patients who do not achieve full remission with therapy alone.
What to know before you search
Eligibility is based on DSM-5 bulimia nervosa diagnosis, binge-purge frequency, and stability for outpatient participation.
What types of trials are currently open
- CBT delivery trials — Comparing face-to-face, online, and app-based CBT programs for binge-purge frequency reduction.
- GLP-1 agonist trials — Testing semaglutide and liraglutide for their effects on binge eating urges and purging behavior.
- Medication trials — Evaluating augmentation of antidepressants with mood stabilizers or other agents in treatment-resistant bulimia.
- Neuromodulation trials — Studying TMS targeting prefrontal and insular cortex as an add-on treatment for refractory cases.
- Integrated therapy trials — Testing combined emotion regulation and CBT programs for patients with co-occurring mood disorders.
Recently added Bulimia Nervosa trials
Cognitive Evaluation of Patients With Eating Disorders
The goal of this cross - sectional observational study is to improve understanding of the psychological and cognitive characteristics of Feeding and Eating Disorders (FEDs), a group of conditions that represent a growing public health concern due to their significant impact on physical health, emotional well-being, and everyday functioning. Within this broader diagnostic category, particular attention is given to Avoidant/Restrictive Food Intake Disorder (ARFID), a diagnosis introduced in the DSM-5 and still relatively underexplored compared to other feeding and eating disorders. Despite its clinical relevance, ARFID remains less well understood in terms of its underlying cognitive and psychological mechanisms. Individuals with ARFID often experience severe food avoidance or restriction that is not driven by weight or shape concerns, but rather by sensory sensitivities, fear of negative consequences of eating, or a lack of interest in food. For this reason, investigating ARFID can offer important insights into the diversity of mechanisms involved in feeding and eating disorders as a whole. The study has two main objectives. The first objective is to examine the cognitive profile of individuals with ARFID, with a specific focus on autistic traits and cognitive flexibility, as previous research suggests potential overlaps between ARFID and neurodevelopmental conditions such as Autism Spectrum Disorders. Cognitive flexibility refers to the ability to adapt thoughts and behaviors in response to changing situations, and reduced flexibility may contribute to rigid eating patterns and food avoidance. The second objective is to explore the role of body representation (how individuals perceive and mentally represent their own body) and inhibitory control (the ability to regulate or suppress automatic responses) in shaping the cognitive and behavioral features of ARFID and other feeding and eating disorders. These processes may help distinguish ARFID from other diagnoses and clarify shared and disorder-specific mechanisms across the FED spectrum. The study involves adult participants of all genders, including individuals diagnosed with ARFID, anorexia nervosa, and bulimia nervosa, as well as healthy control participants without a history of feeding or eating disorders. This design allows meaningful comparisons between different diagnostic groups and with the general population. The main questions the study aims to answer are: Do individuals with ARFID show a distinct cognitive profile, particularly in terms of autistic traits and cognitive flexibility, compared to individuals with other feeding and eating disorders and healthy controls? How do body representation and inhibitory control contribute to differences in eating-related behaviors across feeding and eating disorders? Are there differences in brain activity associated with implicit, automatic attitudes toward food in individuals with feeding and eating disorders compared to healthy individuals? Where comparison groups are included, researchers will compare participants with ARFID, anorexia nervosa, bulimia nervosa, and healthy controls to examine differences in cognitive functioning, psychological characteristics, and neural responses related to food processing. Participants will be asked to take part in a series of non-invasive and well-established research activities, designed to be accessible and safe. These include: Completing self-report questionnaires assessing autistic traits, body image perception, and general psychological well-being; Performing computer-based tasks that assess cognitive flexibility and decision-making; Completing behavioral tasks designed to measure inhibitory control and automatic associations with food-related stimuli;
COR Protocol for the Treatment of Binge Eating in Chilean Adults (COR)
The goal of this clinical study is to learn whether a brief online psychological program called COR can be delivered in a feasible and acceptable way for adults who experience recurrent binge eating. The main questions this study aims to answer are: * Is the COR program acceptable to participants, in terms of satisfaction, adherence, and dropout rates? * Is the COR program feasible to deliver online, including recruitment, retention, and completion of sessions and questionnaires? * Do participants show preliminary changes over time in binge eating-related distress and emotional well-being? Participants in this study are adults who experience recurrent episodes of binge eating. They will take part in an individual online intervention that includes eight weekly sessions, a brief pre-session, and a follow-up session one month after the end of treatment. During the study, participants will: * Attend weekly online sessions focused on understanding binge eating, emotions, and the relationship with food and the body * Practice simple exercises to help manage emotional distress and food-related urges * Complete short questionnaires before, during, and after the intervention to describe their experiences The information from this study will help researchers understand whether this type of intervention can be used in future, larger studies and in real-world clinical settings.
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