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Treatment for Bulimia

What is Bulimia?

Bulimia Nervosa or “bulimia” is a life-threatening disorder where people will consume large amounts of food and then use unhealthy measures to compensate for their “binge” session such as purging, diet aids, diuretics, enemas, laxatives or other diet aids. The first stage of bulimia is the “binge” stage where the person consumes an abnormal quantity of food and then compensates by using unhealthy measures to get rid of the calories.

Bulimia

Today we are going to discuss another serious eating disorder: Bulimia Nervosa.

Eating disorder terms get thrown around a lot, whether socially or in the media and the gravity of how dangerous they are can get lost. I’m here to talk about what bulimia is and what it isn’t.

The first part of bulimia is the binge. This is eating a large quantity of food in a short period of time. Now this could look different from person to person so what really matters to me is how each person defines their own binge. A lot of people struggling with bulimia say it’s almost an out-of-body experience. It’s like turning on a light switch. Maybe not realizing you’re binging until it’s over and the wrappers and receipts are there to show you what has happened. During the binge the person feels completely out of control and afterwards left with that gut wrenching thought of “Oh my god what have I done?”. Up until this point it’s pretty similar to what we have discussed in the binge eating disorder video but this is where it changes.

The second part of bulimia following the binge and the out-of-control behavior is something to make up for the bench to compensate from what has happened. This can also look different from person to person as well. Self induced vomiting laxatives, diuretic stimulants such as crystal meth or cocaine are a few ways people purge the calories that were consumed during a binge. Other behaviors can include excessive exercise, starving, cleansing, and fasting. In this world it gets really confusing where extreme dieting fasting and excessive exercise is not only the norm, but it’s encouraged. Someone struggling with bulimia is highly focused on their body shape and weight which often drives those eating disorder behaviors. This doesn’t mean that everyone on a diet or working out a lot has bulimia. Sometimes people use eating disorder statements loosely. For instance a friend going to the bathroom after eating; “Oh she must have bulimia”

No that’s not entirely true at all. That’s an unqualified and uneducated guess if you will. It’s important to seek help if you’re experiencing any of these binge purge behaviors. Address the disorder head on and find peace with food and your body.

Symptoms of Bulimia

People who suffer from bulimia think about their weight and shape frequently to the point that it affects their life. It’s common for people to think negatively about themselves and hold strict standards on how they look and how much they should weigh.

Some symptoms include:

  • Severe fear of gaining weight
  • Obsessed with body weight and shape
  • Loss of control with eating, binging or what you are eating
  • Using extreme measures such as vomiting or exercise to control your weight
  • Using diuretics, laxatives, enemas or other weight-loss strategies to stay thin
  • Using supplements or other medications to lose weight
  • Mood swings or depression
  • Sore throat from vomiting
  • Heartburn, indigestion or bloating
  • Irregular periods
  • Risking calories or fasting between binging sessions

Diagnosing Bulimia

The DSM-5 is a manual for diagnosing mental health disorders and is published by the American Psychiatric Association. According to the DSM-5 these characteristics are used for diagnosing bulimia nervosa:

  • Persistent episodes of binging or purging. An episode of purging can be described as:
  • Eating a large quantity of food in a specific time frame that is not a typical amount of food for the average person
  • Feeling out of control with eating habits or feeling as though you cannot stop eating
  • Frequently using inappropriate behaviors to lose weight such as the use of laxatives, diuretics, purging, diet aids, fasting or excessive exercise.
  • The binging episodes and unhealthy compensatory behaviors happen once per week for three months.
  • The perception of one’s self is solely based upon body shape, weight, and size.

Types of Treatment

Treatment for bulimia usually involves more than one method and a team of mental health professionals that treat different areas and incorporate their tools to help overcome this disorder.

There is no one treatment that is best suited for each person; treatment needs to be individualized depending on the person’s needs and the seriousness of the disorder. “The American Psychiatric Association (APA) guidelines for treating bulimia nervosa recommend starting with a combination of nutritional counseling and psychotherapy, preferably cognitive-behavioral therapy (CBT).”

Treatment for Bulimia

Nutrition Education

Counseling on healthy eating strategies will help a person break the cycle of binging and compensating for vomiting. Patients learn how to meal plan, balance their diet and eat appropriate proportions that are needed throughout the day.

Cognitive Behavior Therapy

Research suggests that the most successful form of treatment for eating disorders is cognitive behavior therapy. During this type of therapy, a patient learns how to change distorted thoughts and feelings about themselves and food, along with finding better ways to cope with daily stress. Typically, someone in CBT will attend up to 20 sessions or more over five months.

Interpersonal Therapy

This type of therapy treats the problem as a collection of difficulties that are revolved around personal relationships. To address the eating disorder, work is done to improve the relationships in a person’s life.

Support Groups

With the rise in technology, there are new internet-based modes for self-help such as online support groups or message boards. In-person support groups can also help the person feel that they are not alone. Support groups should not be the primary role of treatment and should be used in conjunction with other modes of treatment such as therapy or medication.

SSRI’s

The only medication that is currently approved by the FDA to treat eating disorders is Fluoxetine (Prozac). Most research has been done on adults who suffer from bulimia nervosa, but there are small open trials that suggest it can be helpful for young adolescents as well. A small amount of research has been done on Zoloft and has shown it can also be effective in treating bulimia nervosa.

In treating eating disorders, the dose of SSRI’s usually needs to be higher than when treating anxiety or depression. It may take several tries with different medications to find the one that best works for you and your needs.

Other Medications

Other medications can be used to treat eating disorders but most research shows that they are not as effective as the ones above and some should be avoided altogether. The FDA has issued a “black box warning” which is its’ strongest advisory against using medications such as bupropion (Wellbutrin) because there may be an increased risk for seizures.

The Family Support System

It takes time to recover from an eating disorder and it helps to have a support system when you are going through it. It’s important to be patient and have compassion for the person has an eating disorder. There is no one quick fix or solution that will guarantee a person will get better. Provide support, love, and encouragement to your loved one. Some tips for helping the person include:

Become educated

Learn more about the disorder so that you can better understand what the person is going through and how to help them.

Understand the Triggers

Listen to your loved one’s feelings and struggles without criticizing or giving advice. Let them know you are here for them and be supportive of their challenges. Validate their feelings even if you don’t quite understand what they are doing or why.

Listen Without Judgement

Try not to mention or discuss anything about weight, food, body image or eating. In the same regard, don’t be afraid to eat in front of the person as this can help them see what a normal and healthy relationship with food looks like.

Treatment in Los Angeles

Bulimia is a serious condition that can be fatal if not appropriately treated. If you or someone you love is struggling with bulimia, do not waste one more minute. You can recover from this disorder by attending Breathe Life Healing Center’s eating disorder treatment in Los Angeles.

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