Bulimia Nervoza Tedavisinde Web Tabanlı Bilişsel Davranışçı Terapi: Bir Sistematik Derleme
Web-Based Cognitive Behavioral Therapy in the Treatment of Bulimia Nervosa: A Systematic Review

Summary/Abstract: The primary objective of this systematic review is to comprehensively examine the clinical efficacy, cost-effectiveness, and predictors of treatment response for web-based interventions, telemedicine applications, and guided online Cognitive Behavioral Therapy (CBT) modalities in individuals diagnosed with Bulimia Nervosa (BN). Within the scope of the research, 10 randomized controlled trials and clinical protocols published between 2008 and 2024, comparing technology-assisted interventions with traditional face-to-face therapies, were synthesized and evaluated based on key parameters such as bulimic episode frequency, eating disorder psychopathology, cost analyses, and dropout rates. The findings indicate that web-based interventions significantly reduce bulimic symptoms and clinical impairment compared to control groups, these clinical gains are maintained even during one-year follow-up periods, and internet-based programs demonstrate high success rates in stopping bingeing and purging behaviors. While telemedicine applications were found to exhibit equivalent clinical performance to faceto-face therapies in symptom reduction, it was determined that digital modalities alleviate the financial burden on the healthcare system by minimizing travel and operational expenses. Furthermore, it was observed that emotion-focused interventions yield similar clinical outcomes to enhanced CBT (CBT-E), the level of "rapid response" within the first four weeks of treatment is the strongest predictor of overall recovery, and patient preferences directly influence the risk of treatment dropout. In conclusion, technology assisted interventions offer a clinically effective and cost-efficient alternative in the treatment of Bulimia Nervosa, and the integration of these systems into routine clinical practice is considered to be of strategic importance in overcoming barriers to treatment accessibility.

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