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This paper focused on the experience of the authors in providing nursing care to a patient with bulimia nervosa who sought psychiatric assistance upon her first episode. The nursing period spanned a period from April 21, 2008 to June 16, 2008. After primary diagnosis, relevant data was collected by observation, interview, and a review of medical records. The patient's disease was assessed from five dimensions. Care problems faced for this patient included: altered nutrition profile, abnormal eating patterns, ineffective individual coping, and body image disturbance. The authors adopted a three-stage nursing intervention based on cognitive behavior theory (CBT). First, a caring attitude was employed to establish a good nurse-patient relationship, after which the patient was instructed to maintain a diet diary, which could be used to help identify the underlying causes of her bulimia nervosa condition. Secondly, we assisted the patient to express her emotions and feelings in order to help her disentangle herself from unhealthy perceptions regarding body image and weight. Thirdly, we assisted the patient to develop critical problem-solving abilities and coping skills that would help avoid symptom recurrence. We followed up on patient progress by telephone for one month after treatment. The treatment had successfully stabilized her emotions and bulimia nervosa did not recur. Her body weight was kept within a satisfactory range. Furthermore, she applied cognitive behavior skills in daily life continuously, and she did exercise and kept company with an individual who helped reinforce appropriate behavior. It is hoped that this report can help nurses better understand bulimia nervosa and be used as a reference in clinical care.

Eating disorders include anorexia nervosa and bulimia nervosa. The former is characterized by failure to maintain a minimum normal body weight, while the latter is typified by recurrent binge eating followed by inappropriate compensating behavior, which may include self-inducing vomiting; abuse of laxatives, diuretics or other medications; fasting; and over-exercise. Because eating disorders are difficult to detect in the early stages and patients frequently try to hide their condition and avoid seeking medical help, medical treatment is sometimes sought only once a patient's condition poses an immediate threat to his/her health, or even life. Some patients suffer from chronic and treatment-refractory disorders. Cognitive behavioral therapy, administered through partially-structured guidance and education, has been shown to treat eating disorders effectively by correcting associated maladaptive and distorted cognitions and behaviors. A review of articles published in the domestic and international literature over the past five years show that cognitive behavioral therapy is more effective in treating eating disorders than other traditional approaches. Therefore, we chose to focus this study on the cognitive behavioral therapy model. Nurses can employ cognitive behavioral therapy to help eating disordered patients address and overcome the core beliefs that underpin their disorder (e.g., compulsive concern about body weight or figure) and recover health.