When you have bulimia, you may need several types of treatment, although combining psychotherapy with antidepressants may be the most effective for overcoming the disorder.
Treatment generally involves a team approach that includes you, your family, your primary care doctor or other health care provider, as well as a mental health provider and a dietitian experienced in treating eating disorders. You may have a case manager to coordinate your care.
Here's a look at bulimia treatment options and considerations.
Psychotherapy, also known as talk therapy or psychological counseling, involves discussing your bulimia and related issues with a mental health provider. Evidence indicates that these types of psychotherapy help improve symptoms of bulimia:
- Cognitive behavioral therapy to help you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones
- Family-based therapy to help parents intervene to stop their teenager's unhealthy eating behaviors, then to help the teen regain control over his or her own eating, and lastly to help the family deal with problems that bulimia can have on the teen's development and the family
- Interpersonal psychotherapy, which addresses difficulties in your close relationships, helping to improve your communication and problem-solving skills
Ask your mental health provider which psychotherapy he or she will use and what evidence exists that shows it's beneficial in treating bulimia.
Antidepressants may help reduce the symptoms of bulimia when used along with psychotherapy. The only antidepressant specifically approved by the Food and Drug Administration to treat bulimia is fluoxetine (Prozac), a type of selective serotonin reuptake inhibitor (SSRI), which may help even if you're not depressed.
Nutrition education and healthy weight
Dietitians and other health care providers can design an eating plan to help you achieve a healthy weight, normal eating habits and good nutrition. If you have bulimia, you may benefit from a medically supervised weight-loss program.
Bulimia can usually be treated outside of the hospital. But if you have a severe form and serious health complications, you may need treatment in a hospital. Some eating disorder programs may offer day treatment rather than inpatient hospitalization.
Treatment challenges in bulimia
Although most people with bulimia do recover, some find that symptoms don't go away entirely. Periods of bingeing and purging may come and go through the years, depending on your life circumstances, such as recurrence during times of high stress.
If you find yourself back in the binge-purge cycle, "booster" sessions with your health care providers may help you weather the crisis before your eating disorder spirals out of control again. Learning positive ways to cope, creating healthy relationships and managing stress can help prevent a relapse.
Dietary supplements and herbal products designed to suppress the appetite or aid in weight loss may be abused by people with eating disorders. Weight-loss supplements or herbs can have serious side effects and dangerously interact with other medications. If you use dietary supplements or herbs, discuss the potential risks with your doctor.