Skip to main content

Cognitive Behavioral Model Of Bulimia Nervosa (Fairburn, Cooper, Shafran, 2003)

Bulimia nervosa is an eating disorder characterized by binge eating followed by purging. Among young women, the point prevalence of bulimia is about 1%. This is a cognitive behavioral model of bulimia nervosa, and forms part of the transdiagnostic model of eating disorders.

Download or send

Choose your language

Notice: The 'Fillable PDF' format has been retired. For resources with form elements, both the 'Professional' and 'Client' versions are now available as fillable PDFs by default.

Professional version

Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.

Translation Template

Are you a qualified therapist who would like to help with our translation project?

Tags

Languages this resource is available in

  • English (GB)
  • English (US)

Problems this resource might be used to address

Techniques associated with this resource

Mechanisms associated with this resource

Introduction & Theoretical Background

Fairburn, Marcus & Wilson (1993) proposed that a dysfunctional system for evaluating self-worth is primary to the maintenance of bulimia nervosa. Instead of evaluating one’s self-worth based on a broad range of criteria they argue that people with bulimia judge themselves “largely, or even exclusively, in terms of their eating habits, shape, or weight (and often all three) and their ability to control them.” The ‘problems’ of bulimia nervosa, such as weight-control behavior and preoccupation with weight, are seen as resulting from this primary mechanism. 

In the extended 2003 theory a number of additional maintenance mechanisms were added to the model. It was proposed that these only operate in some patients, and include:

  • Clinical perfectionism
  • Core low self-esteem (persistent and pervasive negative self-beliefs that are viewed as part of the individual’s self-identity)
  • Mood intolerance (difficulty coping with strong mood states)
  • Interpersonal difficulties

Fairburn, Cooper & Shafran (2003)

Get access to this resource

View all plans and pricing options

Get Access

Therapist Guidance

This is a Psychology Tools information handout. Suggested uses include:

  • Client handout – use as a psychoeducation resource
  • Discussion point – use to provoke a discussion and explore client beliefs
  • Therapist learning tool – improve your familiarity with a psychological construct
  • Teaching resource – use as a learning tool during training

Get access to this resource

View all plans and pricing options

Get Access

References And Further Reading

  • Fairburn, C. G., Cooper, Z., Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: a “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41, 509-528.
  • Fairburn, C. G., Marcus, M. D., & Wilson, G. T. (1993b). Cognitive-behavioral therapy for binge eating and bulimia nervosa: a comprehensive treatment manual. In C. G. Fairburn, & G. T. Wilson (Eds.), Binge eating: nature, assessment and treatment (pp. 361–404). New York: Guilford Press.

Get access to this resource

View all plans and pricing options

Get Access