Treatment of Bulimia

Bulimia, like all eating disorders, is a complex mix of problems. Although it is a chronic illness, bulimia can run in stops and starts. In addition, other factors like substance abuse or other personality disorders are often associated with the illness. Because bulimia is a relatively “new” illness (first diagnosed in the 1980’s), the long-term success of treatment has yet to be determined. In order for treatment to work, each problem must be diagnosed, confronted, and a solution found.

Just as bulimia is a mix of problems, an effective treatment program addresses the problems using a mix of the following therapies:

1. Physical Evaluation
   A complete medical examination is usually necessary to evaluate the individual’s physical health. Many bulimia patients often suffer from medical complications due to overuse of laxatives or self-induced vomiting. Later therapies prove more effective when they can focus on social-behavioral criteria after physical problems have been isolated and resolved.
2. Medication (where indicated for either physical or emotional problems)
   Medications play an important role in the treatment of bulimia. Aside from those used to alleviate physical problems, some medications help to decrease the urge to binge and purge. In addition, anti-depressant medication can be a critical factor in helping the individual work through emotional problems. However, medication should be carefully monitored, especially in the first stages of treatment where the patient may still be vomiting or taking large amounts of laxatives since these behaviors may impact their effectiveness.
3. Individual psychological counseling
   Psychotherapy helps people with bulimia change the way they perceive themselves, work through emotional problems, and modify their eating behaviors. Cognitive-behavioral therapy, which focuses on issues of self-image and self-evaluation, has been the most valuable type of therapy in successful treatment of bulimia.
4. Nutritional counseling
   Nutritional counseling helps people understand healthy eating. In addition to providing education about healthy foods, it also helps the patient define a healthy body image and educates them about the potential risks of unhealthy habits.
5. Group counseling
   One of the most powerful advantages of group counseling is that it allows the individual to interact with others who have bulimia. A group takes the bulimic out of isolation, helps erase guilt feelings, and provides them with support as they progress through treatment. An added bonus for group counseling is that in today’s managed-care society, it is cost effective as well. 
6. Family counseling
   Family therapy helps the individual’s family to understand bulimia and gives them the tools to support their loved-one’s efforts to overcome the illness. It can also help uncover family behaviors and issues that are reinforcing the bulimic’s binge and purge behaviors.
7. Support groups
   Self-help groups are especially effective in providing on-going support both during and after treatment. They are a haven for the recovering individual to find understanding in a world that doesn’t understand the problem of bulimia. Individuals can share experiences, feelings, fears, and successes. A good support system is crucial to quick recovery.

People with eating disorders have an excellent chance of recovery, especially if their condition is recognized early. Although treatment may not eliminate all problems, treatment allows the individual to confront the illness, provides the tools to solve the underlying problems and ultimately resume normal healthy activity.

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