Treatment Options For Bulimia Recovery
Eating disorders are serious conditions characterized by eating habits that can disrupt one’s daily life and lead to significant long-term effects. Bulimia nervosa is one of the most common eating disorders—it is estimated that over 3 million people in the US have experienced bulimia nervosa at some point.
Bulimia recovery and treatment
There are a variety of treatment options and recovery techniques that can help you manage your symptoms and improve your emotional well-being. Below, we’re covering the ins and outs of treatment for bulimia.
You deserve to have a healthy relationship with foodWhat is bulimia?
According to the National Eating Disorder Association, bulimia nervosa is marked by the tendency to binge eat, and then compensate for the binge through methods such as purging (self-induced vomiting or taking laxatives), excessive exercise, or fasting. People who struggle with it often experience discomfort and a lack of control surrounding their food intake and then guilt over the binges, which can make them experience the need to reverse the effects of the binges. This binge-purge cycle in bulimia nervosa is different from anorexia nervosa where individuals reduce food intake or stop eating altogether. It is also different from the binge eating behaviors in binge eating disorder (BED) because those with BED typically don’t partake in purging.
While an estimated 9% of the global population has experienced an eating disorder, it may be difficult to grasp the true prevalence of conditions like bulimia nervosa because many people do not report their condition. Individuals may keep bulimia a secret for different reasons, including perceived stigma or fear of repercussions.
If you’re living with bulimia, know that you’re not alone, and you deserve support and recovery.
Potential long-term effects of the eating disorder bulimia
As discussed above, due to stigma and societal pressures, it can be difficult to ask for help with bulimia nervosa. However, recovery can be vital to one’s mental and physical health. Along with the disruptions eating disorders can cause in one’s life in the present, long-term side effects can also arise. Long-term physical effects from bulimia include stomach ulcers, reduced bone mineral density, and electrolyte imbalances that can lead to heart failure, among other complications.
Paradoxically, weight gain is a common symptom, partially due to the high level of calories consumed prior to expulsion. One study found that 60% of participants with bulimia experienced weight gain as a result of disordered eating.
Early intervention is often the key to avoiding these outcomes and recovering from symptoms. Below, we’re covering several different recovery methods.
Bulimia recovery
Recovery treatment can take many forms. The exact recovery program an individual pursues for bulimia will generally depend on a healthcare professional’s guidance and may vary based on personal circumstances, including the severity and duration of their condition, medical history, and lifestyle factors.
Psychotherapy for bulimia recovery
Managing bulimia symptoms is often a matter of helping the individual develop a healthy relationship with food. Because the root causes can often be traced to mental or emotional health challenges, therapy is a major component of bulimia recovery for many people.
Often, due to the stigma surrounding eating disorders and other concerns, people keep their bulimia a secret, which may make eating disorder recovery more challenging. Beyond simply serving as someone to open up to, a counselor can help you develop recovery strategies and coping methods, in addition to connecting you with a treatment team to start your recovery journey. Therapy can also be a crucial part of eating disorder recovery for anorexia nervosa and other types of eating disorders.
Cognitive behavioral therapy (CBT) for bulimia nervosa
One of the most common forms of therapy for the treatment of bulimia nervosa is cognitive behavioral therapy (CBT). CBT aims to help individuals reframe negative thought processes that may lead to maladaptive emotions or behaviors related to eating.
Cognitive behavioral therapy can be performed in either individual or group settings. CBT has been shown to also be effective for disorders that may exist alongside bulimia nervosa, such as anxiety and obsessive-compulsive disorder. While CBT is considered the most effective treatment and recovery method, some experts suggest that therapy is most effective in conjunction with medication, which we’ll discuss later in this article.
It’s important to note that it can be a long-lasting condition that can require ongoing counseling even after symptoms have improved. Online therapy can be a helpful option for someone who has recovered from but would still like support coping with emotional challenges and preventing a relapse.
Interpersonal therapy for recovering from eating disorders
Another recovery modality sometimes used for people living with bulimia nervosa is interpersonal therapy (IPT). IPT focuses on an individual’s relationships, specifically how their interactions with others may impact their mental and emotional health.
IPT was originally designed in depression recovery but started being implemented as a method of bulimia nervosa treatment in the 1990s. Rather than focusing on specific behaviors and coping skills as one would with CBT, IPT focuses on relationships and dealing with conflicts.
Supporters of IPT believe that if the individual learns how to better deal with these things, it will improve their self-awareness and self-confidence. Seeing themselves in a better light can help reduce some emotions associated with this condition, such as anxiety, depression, or loneliness. IPT can help increase the power one perceives over their interpersonal skills and relationships, thus reducing the emphasis on their body image, and allowing individuals to enter into recovery.
Inpatient recovery treatment for eating disorder bulimia
For people with severe or long-lasting cases, inpatient care is sometimes the most effective treatment recovery option. Given the nature of the condition and the common desire to hide symptoms, people can live with it for long periods before deciding to seek treatment. Inpatient recovery treatments often involve the same therapy methods that one would receive in an outpatient setting but with more supervised care involving a recovery team.
Medication for bulimia recovery
Another recovery treatment sometimes used in conjunction with therapy for eating disorders is prescription medication, specifically antidepressants. Antidepressants have been shown to be useful in some people by reducing bingeing and purging urges. Research in clinical psychiatry has shown that people who struggle with bulimia have decreased levels of the neurotransmitter serotonin, which many antidepressants work to adjust. Always consult with a healthcare professional before starting or stopping any medication.
Online therapy for bulimia recovery
Studies show that online therapy can lead to improvements in the symptoms of an eating disorder like bulimia. In one study, researchers found that online therapy significantly improved disordered eating and reduced depression symptoms in participants. The study also mentions that online therapy can help eliminate common barriers to mental health care, such as geographical limitations.
If you’re living with an eating disorder, online therapy can provide you with thorough, available mental health care. With online therapy through BetterHelp, you can talk through challenges related to bulimia or other topics remotely, through video calls, voice calls, or in-app messaging. You can also schedule appointments every few weeks or when it is convenient for you.
Takeaway
Frequently asked questions (FAQs)
Below are some questions you may ask your therapist about bulimia recovery:
What is the best way to recover from eating disorders such as bulimia nervosa and binge eating?
Recovery from an eating disorder can take many forms. Treatment plans are likely to be highly personalized and tailored to the individual based on the severity of their condition and whether they have any emergent physical health concerns.
Some people with eating disorders may require in-patient care, which may depend on the nature of their symptoms, how long they have had the disorder, how effective other treatments have been, and whether they have physical complications or need medical support for their recovery.
Helping someone with an eating disorder develop a healthy relationship with food can be a part of treatment and is typically accomplished through psychotherapy. People with eating disorders may keep their condition a secret, which can make diagnosing and treating eating disorders more challenging. A therapist can give people valuable insights about their illness and help them learn the coping skills to manage their recovery.
Cognitive-behavioral therapy (CBT) is commonly used to treat eating disorders. This type of talk therapy can help people reframe patterns of unhelpful thoughts and change maladaptive behaviors.
Another approach to therapy for eating disorders is interpersonal therapy (IPT). This treatment focuses on relationships and how one’s interactions with others impact their emotional and mental health. IPT can help someone with an eating disorder improve their self-esteem and self-confidence, which can reduce body image issues and help them through the recovery process.
Antidepressants can also be used in conjunction with therapy for people with eating disorders. Studies have found that fluoxetine, an SSRI antidepressant, reduced binge eating episodes in individuals with bulimia by around 50–67%, purging by around 50–56%, and may also prevent relapse.
What can I replace binge eating with?
To stop binge eating, it can be more beneficial to identify and treat the things that are contributing to the condition than to replace it with something else. Here are some tips for overcoming the urge to binge.
- Avoid the temptation to binge by not keeping your favorite binge foods in your home.
- Learn to distinguish between emotional and physical hunger.
- Stick to scheduled meal times.
- Incorporate healthy fats into meals to help you feel full.
- Distract yourself when bored by taking a walk, reading, gardening, or calling a friend.
- Eat more mindfully by slowing down, savoring your meals, and listening to your body's hunger cues.
- Do not eat meals while doing something else, like playing on your phone or watching TV.
- Don’t deprive yourself. Strict dieting can make you feel deprived and increase the urge to binge.
- Identify the emotions and circumstances that make you feel like binging.
- Keep a diary to track your mood and food intake.
- When you get the urge to binge, try to delay giving into it as long as you can, aiming for a minute, then two, etc. Eventually, the urge will pass, and you can avoid the binge.
- Adopt beneficial health habits. Establish a regular exercise routine, prioritize sleep, manage stress, and stay engaged with friends and loved ones.
- Work with a therapist to help you learn more about how to manage your emotions to help you resist the urge to binge.
What is the daily life of someone with this eating disorder?
While most people with bulimia share similar eating disorder symptoms, everyone will experience it in their own way. According to the National Eating Disorders Association, some common disordered eating behaviors that may be present in bulimia patients include:
- Evidence of binge eating, like the disappearance of large amounts of food in a short period of time or empty containers or wrappers indicating that a large amount of food has been consumed
- Evidence of purging, like frequent trips to the bathroom after meals
- Frequently weighing themselves on the bathroom scale or looking at themselves in the mirror
- Skipping meals or eating only small portions
- Fear of eating in public or around other people
- Hoarding or stealing food
- Avoiding various foods or food groups
What is the best thing to do for bulimia nervosa recovery?
The best thing to do for recovering bulimia nervosa or other eating disorders may be to ask for help. Due to the stigma around eating disorders and mental health, some people may find it difficult to open up about their condition. If you are experiencing warning signs of bulimia or symptoms of another serious eating disorder, consider reaching out for professional help.
How do people cope with bulimia nervosa and binge eating?
Managing the symptoms of an eating disorder can be a lifelong challenge. Whether you’re just starting eating disorder treatment or have reached a maintenance stage, consider these five key elements to supporting long-term recovery.
- Have a plan for dealing with challenges that will affect your recovery. Things like family gatherings and other social events can present challenges that may lead to stress. Having healthy coping skills to turn to can help you maintain control of your symptoms.
- Prioritize self-care and embrace health to build new habits. Regular exercise, getting enough sleep, and eating a nutrient-rich diet can help you manage daily stress.
- Be kind to yourself. Managing a condition like an eating disorder can be difficult, and it can take a long time. Treating yourself with compassion and grace can be beneficial for long-term management of this condition. Instead of trying to be perfect, set reasonable goals and give yourself room to make mistakes.
- Set and maintain boundaries. Tell friends and family members your boundaries, and stick to them. For example, if people telling you to eat more triggers your symptoms, talk to your loved ones early and often to let them know to be more aware of the words they are choosing.
- Get help when you need it. Recovering from an eating disorder can be a long journey, and you may have ups and downs. Whether you have not sought help before or have been through treatment and feel like you need more support, help is available.
Can your body heal from binging and purging?
The eating disorder behaviors associated with bulimia can lead to various complications and cause physical damage to the body. Some of these can include a hole in the stomach, kidney problems, and an inflamed esophagus. It can also affect blood pressure and other vital signs, like heart and respiration rates, and dental problems and bulimia often go hand in hand.
However, research has found that this damage is mostly reversible with nutritional recovery and behavioral changes; full physical recovery may be possible.
What is the first step in the treatment of eating disorders?
The first step in bulimia treatment or the treatment of other eating disorders depends on the severity of the condition. People with eating disorders who have life-threatening physical complications may need in-patient medical care before moving forward with other treatments.
Once someone is diagnosed with an eating disorder, their care team will develop a treatment plan to guide them through the healing process. Effective treatment plans can take a holistic approach, using a care team that includes physicians, dieticians, and behavioral health professionals. Some people may require a broad support system in early recovery and advance to self-help programs or support groups after they successfully make it through the early stages, but it can be helpful to remember that one of the key elements of an effective treatment plan can be that it is highly individualized.
How long does it take to stop binging and purging?
Treatment for bulimia and other eating disorders takes time. Depending on how long the symptoms have been occurring and whether there are other medical or mental health conditions to address, treatment can take months or years.
Is an eating disorder a mental disorder?
Yes, an eating disorder is a mental disorder, and it often occurs alongside other conditions, like obsessive-compulsive disorder, anxiety disorders, and mood disorders.
While eating disorders can be challenging to overcome and full recovery can be difficult, most people treated for anorexia or bulimia will achieve long-term recovery.
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