Guided self-help for Bulimia Nervosa: A comparison of individual and group provision.

This service evaluation examines the implementation of Guided Self-Help (GSH), a cognitive-behavioral therapy (CBT)-informed first-line treatment for Bulimia Nervosa (BN), delivered in both individual and group formats within a National Health Service (NHS) community eating disorder service. Results from 61 participants showed significant improvements in eating disorder symptoms and depressive symptoms across both modalities, with individual GSH demonstrating greater effectiveness for those with more severe depressive symptoms. Group GSH, delivered online, was found to be feasible, acceptable, and cost-effective, supporting its use as a first-line intervention for individuals with mild to moderate BN or Other Specified Feeding or Eating Disorder (OSFED). The study highlights the importance of considering baseline depression severity, measured by the Patient Health Questionnaire-9 (PHQ-9), when allocating patients to treatment formats and suggests further research into group GSH for other eating disorder diagnoses and early intervention pathways.