A doctor can do a mental health assessment including asking you about your history of bingeing and purging episodes, mood and psychological issues. The doctor will also need to do a physical examination, blood tests and other investigations in case of any medical complications. Many people with bulimia nervosa find it difficult to seek help. They may feel guilty or ashamed of their behaviour.
But there is often a sense of relief after getting a diagnosis of bulimia nervosa because it can lead to successful treatment and recovery. The first step is to see a doctor, who can then provide a referral to a psychologist , psychiatrist or dietitian as needed. Treatment usually begins with psychotherapy , such as cognitive behaviour therapy CBT , family-based treatment for children and adolescents and other kinds of therapy.
This can help to overcome unhelpful thinking patterns about weight and body image , as well as improve mood and anxiety. It is important to restore healthy eating habits, and seeing a dietitian for nutrition advice can be very helpful.
Some people with bulimia nervosa may be treated with an antidepressant to reduce their anxiety and improve their mood and self-control. Self-help tools can also help. Read more about self-help tools.
Recovery can be a slow process and some people have relapses along the way. You can help your recovery by making sure you stick to your treatment plan, even if eating that way makes you feel uncomfortable. Try not to weigh yourself or look in the mirror all the time. Talk to your treatment team about what sort of exercise you can do. You can talk to your doctor or a dietitian about what food you need to stay healthy.
Be kind to yourself. You can encourage a healthy relationship with body weight and food in your children by building their confidence and pride in things other than how they look. Sitting down to eat together as a family, making eating enjoyable and discouraging dieting are all important ways of preventing an eating disorder. Bulimia nervosa can cause serious damage to physical health, especially if purging is involved. Some of the physical symptoms of bulimia nervosa may include:.
If you think you or someone you know might have bulimia nervosa, contact the following organisations for support, information and counselling:. Learn more here about the development and quality assurance of healthdirect content. People with bulimia nervosa often place an excessive emphasis on body shape or weight in their self-evaluation. Bulimia Nervosa is a serious, potentially life threatening mental illness. Read more on Butterfly Foundation website. Eating Disorders Victoria provides information on bulimia nervosa, warning signs, the physical effects, and treatment and recovery options.
Read more on Eating Disorders Victoria website. Bulimia nervosa is a mental and eating disorder. People eat in an out of control way and then purge. Read about bulimia signs and getting help for teens. Read more on raisingchildren. Therapy, particularly cognitive-behavioral therapy CBT , is the leading evidence-based treatment for bulimia. Multiple therapies can be used concurrently, such as CBT and nutrition therapy, and may be combined with medication if necessary.
Team members that might be involved in treatment for bulimia may include a:. Nutrition therapy is usually led by registered dietitians who have specialized training and experience in treating eating and feeding disorders.
The goals of nutrition therapy for bulimia include:. Nutritional counseling may explore topics such as:. The goal of a healthy diet is to eat a variety of nutritious foods from different food groups, without deprivation. One sample guideline to follow is to break down food consumption into thirds:.
Avoid excessive consumption of saturated fats from processed foods. CBT is a type of psychotherapy talk therapy that involves a person facing their own fears, learning to understand their personal behaviors and those of other people, and learning how to use problem solving to help manage difficult situations. CBT focuses on changing thought patterns that are distorted, problematic, and unhealthy into healthier, productive ones.
CBT treatments aimed toward eating and feeding disorders have been developed and continue to evolve. This treatment targeted bulimia specifically. From there, a more comprehensive approach to treating eating and feeding disorders was developed.
Instead of focusing on individual diagnoses like bulimia alone, enhanced cognitive behavior therapy CBT-E addresses the psychopathology of all eating disorders. CBT-E was designed for use with adults in an outpatient setting, but it can be adapted to suit younger people and different therapy types such as day-patient or in-patient therapy.
CBT-E treats the eating disorder as part of the person, and the person with bulimia takes an active role in all areas of the treatment. They are kept fully informed and have the final say on all decisions regarding their treatment. While suggestions and encouragement are offered, they are never asked to do anything they do not want to do.
During CBT-E, people with bulimia learn how to identify the thought processes and behaviors that contribute to their eating disorder, and how those play out in their lives.
They are given help examining their concerns about shape, weight and eating, and other harmful behavior surrounding their disorder. Changes to thinking and actions can lead to healthier outcomes. CBT-E occurs in four stages:. Stage If the person with bulimia is underweight, treatment begins with encouraging the person to choose to regain the weight back to an expected range and helping them to do so.
Once a weight necessary for health has been achieved, the focus shifts to healthy weight management. A study supports the use of CBT for the treatment of bulimia, but notes that it is not effective on its own for every person with bulimia, and suggests alternate or supplemental treatment may be necessary.
While originally developed to treat borderline personality disorder, DBT has shown effectiveness in treating other mental health disorders, including bulimia. DBT explores seemingly contradictory goals of acceptance and change.
People participating in DBT are encouraged to both accept themselves as they are and be motivated to change unhealthy behaviors. The four essential components of DBT are:. DBT can be conducted as part of individual therapy or group therapy. For more mental health resources, see our National Helpline Database.
FBT also called the Maudsley Approach is used mostly with adolescents and children. It involves the whole family, especially the parents, in the treatment plan. The premise of FBT is that the adolescent with bulimia is not in control of their behavior, but rather the condition controls them. With this approach, parents are seen as attacking the disorder itself without being critical of the adolescent. As the treatment progresses, control is gradually shifted back to the adolescent.
Parent-focused treatment PFT is another form of therapy that is similar to FBT, except the parents and adolescent are seen separately. CBT is still the preferred choice of psychotherapy for bulimia, and FBT appears to be more effective for anorexia than bulimia. Still, FBT is an option for treatment, and studies on its efficacy with bulimia are ongoing. Support groups provide an opportunity to meet others who understand your experiences and feelings.
They can also be a place to find contacts for other valuable resources. To find support groups in your area or online, try checking in with:. Support groups are not a substitute for comprehensive treatment, but they can be helpful as a complement to treatment for people with bulimia.
Psychotherapy and nutrition therapy are not always enough on their own to treat bulimia, particularly with the high rates of comorbidity that come with bulimia. One survey showed that Vomiting can also lead to risk of dehydration. To avoid this, make sure you drink plenty of fluids to replace what you have vomited. Antidepressants should not be offered as the only treatment for bulimia.
But you may be offered an antidepressant, such as fluoxetine Prozac , in combination with therapy or self-help treatment, to help you manage other conditions, such as:. Most people with bulimia will be able to stay at home during their treatment. You'll usually have appointments at your clinic and then be able to go home. Your doctors will keep a very careful eye on your weight and health if you're being cared for in hospital.
They will help you to reach a healthy weight gradually, and either start or continue any therapy you're having. Once they are happy with your weight, as well as your physical and mental health, you should be able to return home. Page last reviewed: 10 November Next review due: 10 November Treatment - Bulimia. Treatment may take time, but you can recover from bulimia.
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