The primary treatment for bulimia often combines psychotherapy, antidepressants, and nutritional counseling.
It is helpful to find a psychologist or psychiatrist experienced in dealing with eating disorders. The same is true for nutritional counseling, whether the patient sees the family doctor or another health professional.
Clinics that specialize in eating disorders can often provide psychiatrists, psychotherapists, and nutritionists. All therapists involved should work in close cooperation with one another.
Psychotherapy and Bulimia
Psychological treatments for bulimia may involve individual, family, or group psychotherapy. Behavior or cognitive therapies are often prescribed, as well. Behavior therapy focuses on altering habits (such as bingeing and purging). Sessions are usually devoted to analyzing the behavior and devising ways to change it, and the patient follows specific instructions between sessions.
Cognitive therapy focuses on exploring and countering the negative thoughts that underlie destructive habits. Individual or group psychotherapy focuses on the underlying emotional experiences and relationships that have contributed to the bulimia.
Medications for Bulimia
Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) -- including Prozac, Zoloft, Celexa and Lexapro -- in combination with psychological therapies, are now a mainstay in bulimia therapy. The antidepressant Wellbutrin, popular in part because of its especially low risk for causing weight gain, is usually avoided because it can increase the risk for seizures in patients with electrolyte abnormalities from vomiting.
Alternative Choices for Bulimia
Most alternative therapies for bulimia do not address the root causes of the disorder, but they can be helpful in relieving some of the physical distress resulting from it. If you want to include this type of treatment in your recovery, it is important to consult practitioners who are experienced in dealing with eating disorders. And be sure to tell your doctors and therapists about any complementary therapy you receive, such as acupuncture or biofeedback.
Bulimia and Mind/Body Medicine
Body exercises such as yoga, tai chi, qigong, and dance can help bulimics with their problems of body image. Reprogramming mental processes to gain control over the binge-and-purge cycles is another approach. Either hypnotherapy or EEG biofeedback may help. If you seek help here, be sure to ask hypnotherapists or biofeedback practitioners about their experience in treating eating disorders. And again, tell your doctor and other therapists about the care you get.
Nutrition and Diet's Role in Bulimia Treatment
A nutrient-dense, sugar-free diet may help reduce binge eating. Also, eliminate alcohol, caffeine, flavor enhancers, most salt, and cigarettes. Eat a balanced diet, supplemented daily with vitamin C (1,000 milligrams), vitamin B complex (50 milligrams), and a multivitamin/multimineral supplement.
Remember that treatment probably will include some retraining on how you think about food, eating, and your body. Treatment may be needed over a long period to try to win control over the binge-purge habits.