If you or someone you know has abnormal eating habits, including repeated binging and purging episodes, getting help is very important. Bulimia treatment is a crucial part of the recovery process. Bulimia a serious eating disorder that requires medical attention.
Getting Started
Whether you're struggling with bulimia or you care about someone who exhibits symptoms of this devastating eating disorder, getting professional help is an essential part of recovery.
Admitting You Need Help
Recognizing that there is a problem is the first step. Once you realize that you or your loved one has a problem, you should find someone to speak with about your concerns. This could be a friend or parent, or it could be a health care provider.
Finding a Specialist
As a second step, you and your family should find an experienced health care provider in your area that can guide your treatment plan and create your care team; your primary care physician is often a good place to start. Local hospitals or medical centers may also help you find a specialist; your school counselor or nurse may be helpful as well.
While there will be several types of participants on your health care team, you will have your first visit with primary care physician or a psychologist. The Yellow Pages can offer some suggestions; other people who specialize in eating disorders can be found on the following websites:
Meeting Your Care Team
Your specialist will bring in additional team members as appropriate. The members of your team handle different parts of your care but all work together to make you better. Your health care team may consist of the following individuals:
- A primary care physician
- A psychiatrist
- A nutritionist
- A clinical psychologist
- A psychopharmacologist
- A social worker
- An insurance claims advocate
- Other professionals who administer supplemental services such as alternative therapies
In today's environment, your insurance coverage and your ability to pay may influence your caregiver selections. Your choice of providers may be limited by your insurance plan; however, your family could pay the additional costs to use the clinicians or centers of choice out-of-pocket.
Addressing Any Health Concerns
The next step will be a health assessment. If there are health problems related to the eating disorder, your health care team will work to correct that first -- usually through hospitalization. For a patient with severe bulimia or bulimia resistant to outpatient therapy, the best place for treatment may also be in a hospital or treatment center. During admission, the physicians may prescribe IV nutrition or rehydration for some patients. Often while in the hospital, the person will begin therapy. The patient may then be eligible for day treatment at a hospital or center once progress has been made.
If hospitalization is not needed, you and your therapist can start working on your recovery plan.
Developing a Bulimia Treatment Plan
In most cases, a patient suffering from bulimia is treated with a combination of interpersonal and/or family therapy, nutrition education, and medication. Some providers also include alternative treatments in their plan.
Beginning Therapy
Psychotherapy will be an essential part of your bulimia treatment plan. A therapist helps you address the depression, anti-social behaviors, or obsessive-compulsive tendencies that may be contributing to your binging and purging. Therapists also help you work through issues associated with childhood sexual abuse or other specific traumas that may have had a negative effect on body image and self esteem.
There are different types of therapy to consider if you are seeking treatment for bulimia:
- Cognitive behavioral therapy: This type of therapy helps identify negative thoughts and behaviors and replaces them with more positive ones.
- Interpersonal psychotherapy: The patient looks at problems in personal his/her relationships and helps improve communication and decision-making skills.
- Dialectical behavior therapy: The style of treatment allows the person to recognize stressful or emotional situations and provides tools to better manage one's emotions, stress, and personal relationships.
- Family-based therapy: The parents play an important role in this treatment by helping to correct the teenager's harmful eating habits and dealing with the impact this condition can have on the person and the family as a whole.
The style of therapy that the team may use will depend on the causes of your problems and your family situation. Your therapist -- that either you or your primary care physician found -- will select the most appropriate type of therapy that works for you and your family.
Getting Nutrition Counseling
Nutrition education can help you or your loved one develop healthy eating patterns. For example, many bulimia treatment programs recommended that patients who struggle to recognize the physical signs of hunger plan to eat small meals every three hours. Nutritional therapy also helps to restore gastrointestinal health, stabilize blood sugar levels, and address dietary deficiencies. For example, many bulimia patients suffer from zinc deficiencies that can alter the sense of smell, taste, and appetite.
You may also receive prescriptions for the and other supplements:
- Multivitamins
- Omega 3 fatty acids
- Coenzyme C10
- Creatine
- Probiotics
Nutrition counseling also helps the person with bulimia get back to a healthy weight. In some cases, you or your loved one may need weight-loss counseling too. It's important to follow any guidelines regarding food -- and exercise -- that your physician or nutritionist gives you.
Your therapist or doctor will direct you to a nutritionist but you can find one as well on the Academy of Nutrition and Dietetics website.
Considering Medications
Your doctor may also prescribe medication to help treat bulimia. Researchers have found that fluoxetine, a selective serotonin reuptake inhibitor (SSRI) often sold under the brand name Prozac, is an effective bulimia treatment. Phenytoin and carbamazepine may also be used to help reduce the frequency of a patient's binging episodes.
If you or your loved one suffers from obsessive compulsive disorder, depression, or anxiety, psychiatric medications may be prescribed to treat those associated conditions. However, it's important to realize that prescription medication is only used as part of a complete treatment program. Bulimia is a complex illness that cannot be "cured" with medication alone.
Arranging for Follow-up Care
Unfortunately, bulimia is a disease that requires lifelong treatment. Since relapse is fairly common, it's important that a healthcare provider monitor your weight, exercise habits, and mental health on a regular basis. Establishing a long-term treatment plan and follow-up that is individualized can help you in the future.
Female bulimia patients who later wish to become pregnant will need extensive follow-up care to deliver healthy babies. The nutritional deficiencies caused by repeated binging and purging may have a negative impact on the unborn child. In addition, the physical and hormonal changes that take place during pregnancy can revive old struggles with body image and self esteem.
Establishing a Support Network
Dealing with bulimia may require long-term management, but it does not mean that you cannot move forward with your life. There are organizations like the National Association of Anorexia Nervosa and Associated Disorders Inc (ANAD) that can help you cope throughout your life. You can also find support groups - either online or locally - that may be able to help. Your physician may be able to direct you to one as well.
Be a Participant in Treatment
It is hard to say which types of therapy will work best for a specific person, but your team will incorporate different parts depending on your condition and your response to treatment. Be sure to ask questions; fully participating in your care will help with the recovery. It is also vital to follow your treatment plan and not skip any sessions or stray from your assigned diet. Learning more about your condition also can empower you in managing your part of your treatment. Your recovery depends on your cooperation.
