Treatment of bulimia nervosa

Most people with bulimia will seek treatment themselves though this is usually after a relatively long period of suffering. This is a very brave step because although they wish to be rid of this disorder many cannot imagine life without it and find having a normal relationship with food too difficult to contemplate.

Hospitalization is sometimes necessary for bulimia patients, partly because some become severely under weight and malnourished, and sometimes because of the degree of bulimia and psychological disturbance (for example if the individual has multi impulsive bulimia and has been known to harm themselves).

Medication

Antidepressant medications have been quite successful in bulimia treatment. It is beneficial especially when combined with psychotherapy. Anti depressants reduce obsessive behaviours; reducing such behaviour can help the patient come to terms with their body image issues which are also focused on in therapy sessions. Many studies have found that fluoxetine (Prozac) is particularly successful in bulimia treatment as it is a serotonin reuptake inhibitor. Because serotonin is responsible for mood, fluoxetine keeps it on a single level. Comfort foods are thus not desired so often to lift the mood of the individual, urges to binge are usually suppressed.

Other antidepressants such as monoamine oxidise inhibitors, tricyclic antidepressants and buspione have also shown to reduce the binge purge cycles among bulimics. However fluoxetine remains the most effective with very few side effects.

Blood samples will be obtained by the doctor to check for example iron, potassium (electrolyte levels) and calcium levels. The doctor may then prescribe medication to rectify any imbalances before prescribing anti depressants.

Psychological treatment

Another aim is to help them develop alternative behaviours to triggers (other than binging).Often taught is craving control and how to graduate food intake, provided are methods that develop a healthy diet. For the best recovery and less chance of relapse weekly sessions should be attended for 4 to 6 months. Changing ones thought processes and behaviour is indeed a lengthy process, it needs dedication and hard work from both professionals and the patient. Rome wasn’t built in a day and bulimia is not cured over night!

Family/group therapy can be effective if the self image problems arise from family dynamics. It helps resolve some of the issues that are preventing healthy eating.

Other treatments include;

Dental care: fluoride toothpaste and a soft toothbrush/rinse can combat enamel erosion and rebuild healthy teeth.

Laxative dependency treatment: Medically this is very difficult to treat; the body will slowly adjust as a healthy diet is implemented. The body will gradually depend on laxatives less for bowl function as the frequency of use decreases. Therefore treatment includes educating the individual of the risks involved; such as electrolyte imbalance (although most are fully aware) and also how little laxatives actually contribute to weight loss. To encourage healthy bowl function whilst beginning a healthy diet; natural, herbal tablets that contain senna should be introduced (such as senokot), these do not cause muscles to constrict nor do they remove vast amounts of fluid from the body. Hey work with the body and can help restore normal function, they should not replace the use of laxatives but instead be used to wean oneself off of laxatives so the bowels can become unaided in function.

Nutritional therapy: consulting a dietician/nutritionist can be an effective aspect to treatment and recovery. Learning about healthy eating and planning meals can empower the individual and reduce fear about food. Understanding aspects of a healthy diet can help valuable nutrition of the body to be maintained. Most bulimics experience overwhelming feelings about where to start. Seeing a nutritionist can help them ease their body into proper digestion as function of enzymes are slowly restored.

Self help.

Keeping a diary of eating habits, meal plans, targets and routines can give the individual a feeling of control, therefore gaining control through healthy eating can decrease the need to binge as they are. Learning about healthy eating can also reinforce knowledge about what their diet needs.

Self help books are available, these often contain; success stories, positive thinking strategies, FAQs and what to expect from their body/ emotions, how they may feel and how to deal with such feelings. They also provide information about how to increase caloric intake, what to eat and why they should eat certain things. Especially useful for bulimics, some books explain how to monitor their eating, institute a meal plan, learning to prevent binge eating, problem solving and changing their minds. Some use cognitive behavioural techniques which have also been researched to be effective in recovery.

Counselling, interpersonal psychotherapy and cognitive behavioural therapy are types of psychological treatment that address the underlying reasons for the eating disorder, sometimes the individuals will be assigned a life coach who look. This is the most important aspect of treatment as it explores the mental problems that fuel the disorder. Changing the individuals perception of them self and also learn to understand a realistic ideal weight is the main aim on cognitive behavioural therapy.

Self help is not rated enough as a treatment method; this is mainly because there are not many professionals involved. However this method can be very successful. Attending regular support groups consisting of people going through the same thing can be very beneficial in aiding the recovery process. It allows for ideas to be shared, direct feedback on self image, positive reinforcement and motivation. If one member of the group is succeeding then others are likely to feel encouraged to succeed also. An environment filled with trust and understanding can easily be established. Focus groups as part of additional therapy has been researched to decrease relapse percentages among bulimia patients.