Evidenced-based Treatments for Bulimia

Contributor: Crystal Karges, MS, RDN, IBCLC, Special Projects Coordinator at Eating Disorder Hope/Addiction Hope

Happy female patient in 40s registering at hospital reception deContrary to what the general public may believe, bulimia nervosa is a severe and complex psychiatric disease, influenced by strong biological components. While our society and culture, which is often obsessed with losing weight and achieving unrealistic body standards, may portray bulimia as a disease of “vanity”, there is much more to this disorder than meets the eye.

Individuals with bulimia nervosa often engage in repeated binging and purging cycles. For example, an individual with bulimia may have a binge episode that typically lasts anywhere from 1-3 hours. This binge episode might involve in ingestion of an abnormally large amount of food, in which a person eats well beyond their capacity of fullness.

Tremendous Guilt and Shame

Following a binge episode, a person will experience tremendous amounts of guilt, shame, sadness, anger, etc. which often leads them towards compensatory behaviors, such as self-induced vomiting, compulsive exercise, or laxative/diuretic abuse. This behaviors, though destructive, may help alleviate a person’s intense and overwhelming feelings, that are typically present due to underlying issues unrelated to food.

While some individuals may initially engage in dieting behaviors in attempt to lose weight, bulimia nervosa is not just an attempt for weight loss. These destructive behaviors result in harsh medical complications that can severely compromise and individual’s health and wellness. Because these behaviors associated with bulimia are often reoccurring, professional help and assistance is needed to intervene and cease from engaging in binging and purging patterns.

What Has Been Effective in Treating Bulimia?

Medical examWhat evidenced-based treatments have been shown to be effective for the treatment of bulimia? Fortunately, there is a greater awareness and understanding about this eating disorder, and with ongoing research about plausible causes and effective treatment methods, the prognosis for bulimic sufferers is improving.

Current treatment methods for bulimia often combine a therapeutic and medical approach. Medical intervention is needed to address the physical complications and concerns that often result from bulimia. Once a person is medically stable, work can begin to address the underlying issues associated with bulimia. This may include processes through any traumatic event or psychosocial/environmental factor that triggered the development of bulimia.

Psychotherapy Techniques

Many psychotherapy techniques have been shown to be effective in reducing binging/purging urges or in helping a person heal from the underlying issues that are connected with this eating disorder. This includes the practice and integration of:

  • Mindfulness
  • Dialectical behavioral therapy (DBT)
  • Cognitive behavioral therapy (CBT)
  • Eye movement desensitization and reprocessing (EMDR)
  • Interpersonal therapy

Working with a specialized clinician who is trained in these various forms of therapy may be helpful in the recovery process for bulimia.

Medication Management

Pediatrics. Puppy toy with medical equipmentMedication management may also be a helpful aspect of treatment for bulimia. Currently, the drug fluoxetine, known by the brand name Prozac, has been approved by the Food and Drug Administration for the treatment of bulimia.

In research studies, this medication was found to decrease the number of binging and purging episodes in individuals with moderate to severe bulimia. Other antidepressant medications, such as Zoloft and Paxil, may also be helpful in decreasing obsessions with food and weight and in managing underlying depression.

Finding Appropriate Care

If you or someone you love has been dealing with bulimia, it is essential that you find the appropriate help and care you need to overcome these severe eating disorder. By working with a specialized treatment team, you can find an individualized plan that is tailored to meet your unique needs and concerns. Many treatment approaches may be effective in helping you manage and heal from bulimia, and it is crucial to seek out professional assistance to determine what path may be right for you.

If you are not sure where to begin to find help with bulimia, start by finding a health care professional that specializes in eating disorder recovery. Eating Disorder Hope offers a directory of professionals who specialize in eating disorders, and you can locate a professional close to your vicinity. If anything, be sure to confide in someone you trust. The sooner you can speak out about your struggle, the sooner you can being your path to recovery.

Community Discussion – Share your thoughts here!

Are you an individual who has recovered from bulimia nervosa? What aspects of treatment were helpful to your recovery journey? What advice or encouragement might you share with other individuals who are struggling through treatment for this eating disorder?

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on June 19th, 2015
Published on EatingDisorderHope.com