Psychological counseling. Several types of counseling may be useful in treating eating disorders. The two most proven types are:

• Cognitive-behavioral therapy (CBT). CBT teaches the person to understand the triggers of binge eating and to develop coping skills.
• Interpersonal therapy (IT). IT helps the person examine the relationship between interpersonal conflicts and symptoms of bulimia.

Other therapies that may be helpful include:

• Nutritional counseling, which teaches the person to eat three meals and two snacks a day and to avoid unhealthy diets.
• Dialectical behavior therapy, which is a long-term approach that focuses on helping the person regulate emotions. Coping better with life's challenges and negative emotions should help you decrease the binge-purge behaviors.
• Group counseling, which may enhance individual therapy. Often it is helpful to speak with other people who have this condition.
• Family therapy. Family members can be very helpful to their loved one's recovery, especially for an adolescent with bulimia. Family therapy teaches about the disorder and ways to help.

Self-care programs. Organized programs that provide self-help materials, such as manuals or computer-based activities, may be useful in treating eating disorders. But most people who have an eating disorder also need counseling and possibly medicine.

Stress management techniques. Although it is not part of the treatment of bulimia, relieving stress can help during recovery. Techniques for managing stress include:

• Exercising. Regular, but not excessive physical activity is one of the most effective stress management techniques.
• Writing. Research shows that expressing yourself in writing can be a very effective way to reduce your stress level.¹⁰
• Expressing your feelings. Talking, laughing, crying, and expressing anger are normal parts of the emotional healing process.
• Doing something you enjoy. A hobby or other healthy leisure activity that is meaningful to you can help you relax. Volunteer work or work that helps others can be a powerful stress-buster.
• Learning body-centered relaxation. This includes breathing exercises, muscle relaxation exercises, massage, aromatherapy, yoga, and the traditional Chinese relaxation exercises called tai chi and qi gong.
• Learning mindfulness activities. These include learning how to relax your body through self-hypnosis, meditation, imagery exercises, listening to relaxing music, and using humor to reduce stress.

For more information on stress reduction, see the topic Stress Management.