Bulimia - Treatment

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How is bulimia treated?

Patients with bulimia present a variety of medical and psychological complications which are usually considered to be reversible through a multidisciplinary treatment approach. Treatment can be managed by either a physician, psychiatrist, or in some cases, a clinical psychologist. The extent of the medical complications generally dictates the primary treatment manager. A psychiatrist, with both medical and psychological training, is perhaps the optimum treatment manager.

A number of antidepressant medications have been shown to be beneficial in the treatment of bulimia. Several studies have demonstrated that fluoxetine (Prozac), a member of the selective serotonin reuptake inhibitor (SSRI) class of antidepressants, has been effective in the treatment of bulimia. And the U.S. Food and Drug Administration has approved fluoxetine for the treatment of bulimia.

Other types of antidepressants, including the monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, and buspirone (Buspar) have all been shown to decrease bingeing and vomiting in people suffering from bulimia. However, the SSRIs remain the first choice for treatment due to their relative safety and low incidence of side effects.

Other drugs are currently under investigation as possible treatments for bulimia. Examples are the antiepileptic drug topiramate and the serotonin antagonist ondansetron.

Some patients may require hospitalization due to the extent of the medical or psychological complications. Others may seek outpatient programs. Still others may require only weekly counseling and monitoring by a practitioner. Stabilization of the patient's physical condition will be the immediate goal if the individual is in a life-threatening state. The primary goals of treatment should address both physical and psychological needs of the patient in order to restore physical health and normal eating patterns. The patient needs to identify internal feelings and distorted beliefs that led to the disorder initially. An appropriate treatment approach addresses underlying issues of control, self-perception, and family dynamics. Nutritional education and behavior management provides the patient with healthy alternatives to weight management. Group counseling or support groups can assist the patient in the recovery process as well.

The ultimate goal should be for the patient to accept herself/himself and lead a physically and emotionally healthy life. Restoration of physical and mental health will probably take time, and results will be gradual. Patience is a vital part of the recovery process. A positive attitude coupled with much effort on the part of the affected individual is another integral component to a successful recovery.

Bulimia At A Glance

  • Bulimia (also called bulimia nervosa) is a psychological eating disorder.
  • Bulimia is felt to be related to a person's dissatisfaction with their own body image, although the exact cause is not known.
  • Bulimia is diagnosed according to defined criteria.
  • There are two types of bulimia: the purging and nonpurging types.
  • The purging type regularly engages in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.
  • The nonpurging type engages in other inappropriate behaviors such as fasting or excessive exercise, rather than purging.
  • Bulimia can have serious medical complications.
  • The successful treatment of bulimia is often multidisciplinary involving both medical and psychological approaches.
  • The goals of treatment are to restore physical health and normal eating patterns.

Return to Bulimia

See what others are saying

Comment from: canada, 35-44 Female (Patient) Published: January 30

I am bulimic and anorexic. I have had a warped sense of what is attractive and what's not since as far back as I can remember. I was confronted in late teens and received counseling in my early 20's and convinced everyone that I had stopped, but I have continued into my late 30's. I drink heavily whenever I can because it satiates my appetite, and now I struggle with a balance between my eating disorder and alcoholism. The only time I believe I deserve to eat is when I have done an excessive amount of exercise. I live in constant disapproval of myself and I am terrified to ask for help.

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Comment from: Troubled, 13-18 Female (Patient) Published: February 01

I am 17. I have had bulimia since I was 12 years old. Before the age of 12 I had always been a chubby kid, but when my bulimia started not so much but that led to anorexia. By the age of 14 I reached 110 pounds 5'2/5'3 I stopped throwing up and starving myself because I became depressed and stopped going outdoors, I stayed in my room and only left to eat. My binging never stopped so I became obese within a year than moved to a new school then my Bulimia started again and I lost 50 pounds but my bulimia is worse than ever and I don't know how to deal with it. Now I am beginning to have symptoms of diabetes and heart attacks it is very worry some and I don't know how to control myself but first things first I am going to a doctor. p.s. I went to one of those treatment programs for eating disorders in a hospital. I found it made my disorder worse... at the time.

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