Interpersonal Psychotherapy for Bulimia Nervosa

Interpersonal psychotherapy (IPT) is a form of talk therapy that has been shown to be potentially beneficial in helping people with eating disorders, including bulimia nervosa (BN).

Interpersonal psychotherapy

The method’s focus on building better and stronger interpersonal relationships has been connected to reduced symptoms of depression, which is often a co-occurring condition with eating disorders. And the development of overall healthier, fuller personal relationships fostered by IPT can help someone reinforce their support network.

Still, interpersonal therapy for bulimia nervosa should be used as a supplemental treatment approach. It typically works best when paired with other clinical treatments, such as cognitive behavioral therapy (CBT).

But the support gained from IPT can help reduce potential instances of relapse, allowing someone to not just achieve but maintain lasting recovery and build a healthier future.

What is Interpersonal Psychotherapy?

Interpersonal psychotherapy operates on the tenet that a person’s personal relationships have an outsized impact on their mental health. It was initially developed to help people with depression by giving them tools and strategies to overcome interpersonal problems and participate more fully in their life.

IPT is typically a structured, time-limited form of therapy, generally lasting somewhere between 12-16 weeks. [1] Rather than delve into past concerns or traumatic incidents, these sessions have a high focus on the “here and now,” or the issues that are most affecting someone in the present.

As the patient continues to describe their current interpersonal issues, the therapist will help them identify any interpersonal deficits or areas where the person may be self-isolating or otherwise lacking support. The therapist can then help teach the patient tools and techniques to both helpfully readjust their mindset and foster better relationships with the people in their life.

Interpersonal psychotherapy for bulimia.

When is IPT Used?

Many types of mental health problems can lead to difficulty making or maintaining healthy relationships. In these cases, IPT may be recommended for patients.

The method is also typically used for people going through the acute phase of major depression or those who struggle with a depressive disorder as a co-occurring condition with other mental health disorders.

Often, IPT is used for people who are going through a major change. Those experiencing a recent loss, divorce, or even more positive changes like getting married or becoming a parent may need help adjusting to these role transitions and readjusting their social relationships accordingly. [2]

And for the treatment of bulimia nervosa, binge eating disorder (BED), or other types of eating disorders, IPT can help patients smooth over any interpersonal difficulties that may have developed while they were sick, and work on building a stronger, more stable support network for sustained recovery.

How Does Interpersonal Psychotherapy Work?

There are a few different versions of IPT, which have different focuses, including:

  • Dynamic interpersonal psychotherapy: This form of IPT is more inward-focused, designed to help someone better understand their own thoughts and feelings and how that impacts their relationships with others.
  • Metacognitive interpersonal psychotherapy: Metacognitive interpersonal psychotherapy is primarily used when someone has difficulty expressing emotions, in a way that causes their interpersonal relationships to suffer.

Regardless of the type of interpersonal psychotherapy someone participates in, the course of treatment is generally more structured and broken into several phases.

Different Phases of IPT

Interpersonal therapy typically consists of three distinctive phases.

The first phase of IPT is more intake-heavy. The therapist will ask the patient questions to better understand their current key relationships, or lack thereof. This is called their interpersonal inventory.

Moving forward, the interpersonal inventory serves as a guide, helping both the patient and therapist identify the relationships in a patient’s life that are strong, those that need to be developed, or those that may be missing altogether.

The second phase focuses on developing solutions to any interpersonal problems that may have been identified in the first phase.

Working together, a patient and their therapist will develop these solutions and strategies. The patient will then be tasked with implementing these solutions.

Once the patient makes some proactive changes to their social relationships, they’ll follow up with the results at the next session. The patient and therapist will then discuss any positive and negative feelings brought on by these changes and continue to develop potential solutions and new interpersonal strategies.

The final phase of IPT treatment mainly helps a patient prepare for life beyond their weekly sessions. This can be a particularly sensitive phase, as many people undergoing IPT are already dealing with big changes, and those who struggle to maintain relationships may come to appreciate the rapport they develop with their therapist.

During this phase, a therapist will review any problems that have been discussed over the course of treatment, and go over the progress a patient has made. Strategies that worked may be reiterated, and a therapist may encourage the patient to keep working on behavior therapy through other treatment groups or programs.

What to Expect in IPT

Interpersonal psychotherapy has some notable differences from more “traditional” forms of talk therapy.

Less Focus on the Past

You won’t focus on your childhood or other past events to the same degree as you might with a more traditional approach. The goal of IPT is improving the interpersonal functioning and social support you have around you now, not necessarily helping you process the past, although previous events may be discussed if/when relevant.

Conversational Approach

With interpersonal psychotherapy, you may also have a different dynamic with your therapist than with other types of therapy. IPT sessions are usually much more back-and-forth and conversational, with a therapist attempting to get to know and understand who and how you are, right now, and what your day-to-day experiences feel and look like.

Deep-Dive Into Relationships

In the case of someone going to IPT for help with bulimia nervosa or other eating disorders, there will likely be a focus on identifying individuals who can help support the patient’s recovery journey. A therapist will likely also ask about relationships that may be toxic or otherwise triggering. 

In essence, through IPT, you will work to build a strong support network of people you can trust. After most sessions, you will be encouraged to implement the strategies discussed at therapy into your day-to-day life.

How Effective is IPT for Treating Bulimia Nervosa?

In general, people begin to feel more mentally well when they have multiple people in their life with whom they enjoy spending time and whom they feel they can trust. For people struggling with BN, this includes relationships with those who are willing to be supportive of their recovery. [3]

IPT can also help someone avoid adverse interpersonal events, such as arguments or the deterioration of relationships, which can often lead to worsening disordered eating behaviors and thinking patterns. [4]

Interpersonal psychotherapy used on its own is usually not enough to treat bulimia nervosa fully.

Still, on its own, IPT may be inadequate for treating bulimia nervosa. While it addresses important aspects of someone’s life and can help increase someone’s quality of life and sources of social support, it isn’t designed to address the complex psychological and physical issues at the heart of BN and most eating disorders.

IPT as a Supplemental Treatment

As a supplemental treatment or one used in tandem with cognitive behavior therapy or other more traditional treatments for BN, IPT may be particularly effective.

One study found IPT helpful in significantly reducing symptoms of both eating disorders and depression. According to researchers, the twin results were likely closely connected, with the reduction of depressive symptoms likely leading to the reduction of eating disorder symptoms. [5] 

This apparent connection is important, as depression commonly co-occurs with eating disorders, including BN, and can negatively affect treatment or recovery outcomes if not successfully addressed.

Finding Help for Bulimia Nervosa

If you or a loved one are struggling with bulimia nervosa, it’s important to seek help. This condition is dangerous and can even be deadly if left untreated.

It may feel overwhelming to look for proper care, but you can reach out to your therapist, physician, or other trusted medical professionals for help identifying potential next best steps. A number of bulimia hotlines, which allow you to remain anonymous, can also help provide you with helpful information and resources.

Regardless, taking the time to seek out care is an important first step. Recovery from bulimia nervosa is possible, and therapies like IPT may help you or your loved one achieve lasting recovery and build a healthier and happier future.


  1. Interpersonal Psychotherapy (IPT)​. CAMH. Retrieved February 9, 2023.
  2. Rajhans, P., Hans, G., Kumar, V., & Chadda, R. K. (2020). Interpersonal Psychotherapy for Patients with Mental Disorders. Indian Journal of Psychiatry; 62(Suppl 2):S201–S212.
  3. Weissman, M. (2019, November 22). Interpersonal Psychotherapy: History and Future. The American Journal of Psychotherapy; 73(1).
  4. Murphy, R., Straebler, S., Basden, S., Cooper, Z., & Fairburn, C. G. (2012). Interpersonal psychotherapy for eating disorders. Clinical psychology & psychotherapy; 19(2):150–158.
  5. Bäck, M., Falkenström, F., Gustafsson, S.A. et al. (2020). Reduction in depressive symptoms predicts improvement in eating disorder symptoms in interpersonal psychotherapy: results from a naturalistic study. Journal of Eating Disorders; 8:33.

Last Update | 03 - 13 - 2023

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