Bulimia Nervosa

Treatment for bulimia involves Reference psychological counseling Opens New Window and sometimes medicines such as antidepressants. Treatment does not usually require staying in the hospital, although this is sometimes needed. Both professional counseling and antidepressant medicine can help reduce episodes of binging and purging and help you recover from bulimia. Both are long-term treatments that may require weeks or months before you notice significant results. You may need treatment with counseling and possibly medicines for more than a year.

Bulimia that occurs with another condition may take longer to treat. And you may need more than one type of treatment. If you have another condition that commonly occurs with bulimia, such as depression or substance abuse, your doctor may want to treat that condition first.

People who seek treatment for bulimia or another eating disorder may have other health problems caused by the disorder. If you have had bulimia for a long time without treatment, or if you have used substances such as laxatives, diuretics, or ipecac syrup to purge, then you may have a health problem such as dehydration that needs treatment first. In serious cases, these conditions related to bulimia may require you to spend time in the hospital.

Initial treatment

Initial treatment depends how severe the bulimia is and how long you have had it.

If you have no other conditions that need treatment first, then treatment for bulimia usually consists of:

• Psychological counseling, such as Reference cognitive-behavioral therapy (CBT). This often includes Reference nutritional counseling Opens New Window to change certain behavior and thinking patterns. The goals of CBT are to teach you to:
  • Eat three meals and two snacks a day and avoid unhealthy diets.
  • Reduce concern about your body weight and shape.
  • Understand and reduce triggers of binge eating by examining your relationships and emotions.
  • Develop a plan to learn proper coping skills to prevent future Reference relapses Opens New Window.
• Medicines. Reference Antidepressants, such as fluoxetine (Prozac, for example), are sometimes used to reduce binge-purge cycles and relieve symptoms of depression that often occur along with eating disorders.

Ongoing treatment

Continuing treatment will depend on the how long you have had bulimia and how severe it is. Continuing treatment usually consists of:

• Psychological counseling, such as Reference interpersonal therapy Opens New Window or Reference cognitive-behavioral therapy (CBT). The goals of CBT are to teach you to:
  • Eat three meals and two snacks a day and avoid unhealthy diets.
  • Reduce concern about your body weight and shape.
  • Understand and reduce triggers of binge eating by examining your personal relationships and emotions.
  • Develop a plan to learn proper coping skills to prevent future Reference relapses Opens New Window.
• Antidepressant medicines. Reference Antidepressants can help lower the number of binge-purge cycles you have and may also be used to treat another related condition, such as depression or anxiety.

Treatment if the condition gets worse

If you develop other health problems such as dehydration or an esophageal tear because of bulimia, you may need to stay in the hospital or in an eating disorder treatment facility.

Sometimes people with bulimia get discouraged because recovery can take a long time and relapse is common. If you or the person with bulimia feels very discouraged or feels Reference suicidal, call a doctor or other health professional immediately to get help.

What to think about

Treatment with an antidepressant medicine alone may not be enough. The most effective treatment for bulimia may be a combination of psychological counseling and antidepressants.^{Reference 4}

Eating disorders are hard to treat. Recovery may take months to years. The sooner treatment begins, the better the chance for a full recovery.

Unfortunately, many people don't seek treatment for mental health problems. You may not seek treatment because you think the symptoms are not bad enough or that you can work things out on your own. But getting treatment is important.

If you need help deciding whether to see your doctor, read about Reference some reasons why people don't get help and how to overcome them.

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