Treatment for Bulimia Nervosa

Bulimia Nervosa is a mental health condition that is classified as an eating disorder. Global statistics reveal that 0.5% of women and 0.1% of men are affected by Bulimia. It is a serious disease that can be life threatening if the necessary treatment is not sought. In this article, the causes of Bulimia Nervosa are discussed including the options for treatment and how to find the right support and intervention.

What is Bulimia Nervosa?

Bulimia Nervosa is an eating disorder involving the consumption of large amounts of food within a 2 hour period. The person will try to get rid of the excess calories or food by over-exercising, purging, or using diuretics. People affected by Bulimia are concerned about weight gain and suffer from mood instability and withdrawal behaviours. They may develop nutritional deficiencies and mental health problems such as anxiety and depression.

What Causes Bulimia Nervosa?

Clinical researchers are unsure of what causes Bulimia; however, it is thought to involve an interplay between environmental, genetic, and psychosocial factors. It is a mental health condition because individuals rely on a type of binge and purge behaviour to cope with emotional distress.

The most common causes of Bulimia Nervosa include:

  • Genetic – Eating disorders such as Bulimia Nervosa appear to run in families and researchers have concluded that it could have a genetic component.
  • Environmental – Many people who are treated for Bulimia have experienced past abuse, body criticisms, and the pressure to conform to a physical or a performance standard.
  • Psychological and Emotional Conditions – Individuals with Bulimia often have mental health conditions such as anxiety, depression, Post Traumatic Stress Disorder (PTSD), and Obsessive Compulsive Disorder (OCD).

These psychological conditions can be comorbid with Bulimia Nervosa, it can develop before or after the binging and purging behaviours.

The Dangers Associated with Bulimia Nervosa

Bulimia Nervosa is a serious mental health condition and an eating disorder that causes harm to the body with chronic binging and purging behaviour. Heart problems owing to imbalances in electrolytes, ulcer formation, pancreatitis, digestive problems, and lack of energy. People with Bulimia can also experience inflammation of the oesophagus and eventual rupture because of chronic acid reflux. Tooth decay and staining, also known as “Bulimia teeth,” is a common cause of ongoing vomiting.

Other types of health risks associated with the eating disorder include Diabulimia in which insulin is manipulated to facilitate weight loss in those with Type 1 Diabetes. Symptoms can include damage to the organs and peripheral neuropathy.

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Getting Help for an Eating Disorder

Owing to the chronic and the life-threatening symptoms of Bulimia, it is important to seek help from a specialised clinic or healthcare provider. Bulimia treatment consists of a comprehensive programme including psychological care, medical intervention, and, medication, and nutrition counseling. Depending on the severity of the disorder, long term care may be necessary. Such strategies focus on both the mental health of individuals and the clinical attention they need to treat the physical symptoms of binging and purging.

For treatment to be effective, individuals must first recognise that they have a problem and want to seek help for it. Once they reach out to a clinic or a therapist for assistance, a physical assessment is performed to determine the side effects of frequent vomiting on overall health. Any medical conditions that are determined will be treated to minimise long term complications.

Another problem with reaching out for help is that Bulimic individuals often appear as normal weight making it more difficult to determine when they need support or intervention. Most people will only find help when a loved one encourages them to recognise they have a problem or when the physical impact of Bulimia on their health forces them into hospitalisation.

Many people who are managing Bulimia can achieve recovery, but it takes time and requires ongoing support from friends and family. Because individuals are at risk of relapse in response to an emotional difficulty or personal stress, it is important that loved ones educate themselves about the disorder and will therefore be better equipped to help the person who is impacted by Bulimia.

The Treatment Plan Includes:

Counselling is an integral part of treating Bulimia Nervosa because it introduces ways that individuals can cope with stress, anxiety, depression, and mental health challenges. Cognitive Behavioural Therapy (CBT) is one of the most common approaches to treating Bulimia. It focuses on addressing the distorted or unhelpful thoughts that are affecting eating behaviours.

Another important type of counselling is interpersonal therapy which aims to address the difficulties in relationships and potential triggers that individuals find challenging to cope with.

Family therapy is a crucial part of the recovery process when managing Bulimia. Relatives can support individuals who are struggling and encourage them through their progress with special focus on incorporating healthy eating habits.

If the symptoms of Bulimia have become so severe that it affects the general health and well-being of the patient, then most will be hospitalised and supervised during their recovery. Hospitalisation is also advised when there is a suicide risk or possibility of harming oneself.

For comorbidities including anxiety and depression, therapists may advise on the use of prescription medication. This is a highly individualised determination and medication is only recommended on a case by case basis.

Nutrition Counselling
To help those affected by the grip of Bulimia make healthier choices, nutrition counselling is a necessary aspect of treatment. Only when individuals learn how to control their eating habits and understand how healthier dietary choices can help them achieve their weight goals, can they make better choices.

During nutrition counselling, the individual will work with a dietician who can assist where physical problems such as digestive upset are present. By incorporating the correct diet, combined with traditional counselling services to learn how to cope, the proper choice of foods and balanced eating habits can go a long way to assisting individuals in overcoming the struggles of Bulimia Nervosa.

If you are looking for support groups and care services in the UK, the following groups can help you with a treatment plan and advise on options for recovery:

Frequently Asked Questions
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Is Bulimia Nervosa Genetic?
Researchers are not certain about the cause of Bulimia Nervosa; however, they have found a genetic link between Bulimia and it running in families.

Bulimia is also associated with environmental, psychological, and social factors from past trauma and criticism surrounding body shape and ideals to using food and purging as coping strategies.

Is Bulimia Nervosa a Common Eating Disorder?
Bulimia Nervosa affects around 1% of women and is predominant around adolescence and middle aged populations. It affects 0.1% of men and is primarily seen in those in their twenties.

Bulimia is one of the most well-known eating disorders along with Anorexia Nervosa; however, many people struggling with Bulimia manage to maintain a seemingly “normal weight” which is the reason they may not report their symptoms or their disorder.

How Can I Recover From Bulimia?
Reaching out for treatment from a specialised support group and therapist is the best way to start recovering from an eating disorder. Because Bulimia carries such as high health risk and is associated with mental health difficulties including anxiety, depression, and a great probability of relapse, it should be address with professional intervention.

To achieve a healthy recovery from Bulimia also requires the active involvement of family and loved ones. Families need to be educated about healthy and balanced diets and ways of encouraging individuals to stick to a dietary plan. They must understand how important their role is in providing ongoing support.

With a comprehensive support plan including ongoing therapy and the assistance of loved ones, it is possible to achieve a healthy recovery from Bulimia.

Is Bulimia a Form of Mental Illness?
Yes, while Bulimia is an eating disorder, it is a mental health condition because individuals rely on food and habitual (unhealthy) behaviours to cope with stress and challenges in their lives. Bulimia can also lead to physical complications such as heart disease and inflammation of the oesophagus that require ongoing medical attention. To prevent the complications of Bulimia and ensure that the correct steps are taken to improve wellness, it is necessary to receive treatment from an experienced and a certified therapist.
How Can I Support Someone with Bulimia?
The best way to support someone who is battling with Bulimia is to provide a non-judgmental and non-critical approach to their situation. Listening to their needs and assuring them that you will be there to help them through their progress can go a long way to improving their recovery and their well-being.

Because Bulimia Nervosa is such a complex condition, it needs a multi-faceted approach to treatment and a successful recovery. It is also a long term process with a high risk of relapse. This makes the love and support of family and friends an integral part of healing and coping with challenges.

How is Bulimia Diagnosed?
Bulimia must be diagnosed by a licensed and experienced mental healthcare provider. A physical assessment in combination with a psychological evaluation is necessary because of the health risks associated with chronic binging and purging behaviour.

Jason Sheirs
Author / Jason Shiers / Dip. Psych MBACP
Jason Shiers is a Certified Transformative Coach & Certified Psychotherapist who is a specialist in addiction, trauma and eating disorders. He has been working in the field of addiction for 25 years now.