Bulimia

Prevention

There is no known way to prevent bulimia. Treatment can be easier if the problem is detected early.

Treatment

An eating disorder is a complex mix of physical and emotional problems. Healthcare providers try to organize a treatment that will address these problems comprehensively.

The goals of treatment are to:

• reduce or eliminate binge eating and purging

• treat any physical complications

• provide education and motivate the individual to restore healthy eating

• help the individual understand and change harmful thought patterns related to the disorder

• identify and treat any associated mental disorders (for example, depression or anxiety)

• encourage and develop family support

• prevent relapse

Treatment includes nutritional counseling, psychological counseling, and medication, such as antidepressants. A combination of approaches - when they are available - is often the most helpful approach.

Nutritional counseling usually involves developing a structured meal plan, discussed in connection with recognizing body cues and urges to binge and purge.

Psychotherapy helps people with bulimia create a healthy body image, understand and deal with their emotions, change their obsessive-compulsive behaviors related to food, and gain healthy eating behaviors. Cognitive behavior therapy (CBT) is the best studied approach, and it is known to be effective for many. Family and group psychotherapy can be helpful. In practice, many therapists combine elements of CBT, interpersonal therapy and psychodynamic therapy during the treatment. Self-help, sometimes with the guidance of a professional, can help, as can self-help groups.

With or without psychotherapy, medication often helps to decrease the urge to binge and purge. Fluoxetine (Prozac) has been most frequently studied and is effective, as is sertraline (Zoloft). Sometimes people need higher doses than the doses used to treat depression. Because mood and anxiety disorders are often part of the eating problem, medications for these conditions also may help.