Objective: To describe the rationale and use of a new procedure aimed at bringing bingelpurge behavior directly under therapeutic control via the use of planned binges. Method: Research investigating the specific effects of the various cognitive and behavioral components of the standard cognitive-behavioral treatment (CBT) approach for bulimia nervosa is examined in combination with comprehensive reviews of the treatment outcome literature. Results: These reviews suggest that while treatment has largely been effective at reducing binge-purge frequencies, it does not result in the elimination of the presenting problem for a significant proportion of participants. Evidence is presented to suggest that this may be accounted for by cognitive-behavioral approaches employing indirect procedures to bring the disordered patterns of eating under control. The application of the planned binge approach is illustrated by two cases treated at the University of New South Wales Post Graduate Psychology Clinic. Discussion: These cases in combination with the analysis of the potential deficits of the standard behavioral procedures employed in CBT provide tentative support for the use of planned binges as an addition to the strategies currently used in the treatment of binge and purge behavior. In conclusion the paper explores some of the ethical implications raised by asking subjects to engage in their problematic behavior. 0 1995 by John Wiley & Sons, Inc. While binge eating has been a clinically recognized phenomenon for many years (Stunkard, 1959), the recognition of bulimia nervosa as a nosological distinct cluster of symptoms is relatively recent, dating from the late 1970s and early 1980s (American Psychiatric Association, 1980; Russell, 1979). Since then a variety of differing theoreti-
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