Bulimia nervosa (bulimia) is a psychological eating disorder. Its main characteristics are cycles of binging and purging. Individuals with bulimia eat excessive amounts of food, mainly breads, pastas, and sweets, before they stop. This is followed by purging of the food by either vomiting, taking laxatives or diuretics, or obsessive exercising to avoid weight gain. This disorder affects approximately 3% of women in the United States. In men it only affects only about .3% of the population.

From twin and family studies that have been done, it is believed approximately 55% of bulimia is inherited. Triggers in the environment, especially the obsession with being thin, may also affect the disorder. It appears that individuals who have poor self-esteem and self-image, in addition to being perfectionists, are most likely to develop bulimia. Other possible triggers are moodiness or controlling behaviors, sexual or physical abuse, and/or dysfunctional families. It most often occurs in the late teens or early twenties. Binge eating many times is triggered by intense hunger (after deprivation), a depressed mood, or stress.http://www.health.harvard.edu/fhg/updates/treating-bulimia-nervosa.shtml

There are two types of bulimia, purging and non-purging. The purging type vomits or uses laxatives or diuretics to get rid of the excessive amount of food they have eaten. The non-purging type uses exercise in excess or fasts to keep from gaining weight. For more information on causes, signs and symptoms read How to Diagnose Bulimia. This article on How to Treat Bulimia will deal with various treatments such as alternative treatments, lifestyle and home remedies, therapy and medication.

There are several types of treatments that may be involved in helping people with bulimia. In order to get the individual back to a normal eating pattern, their psychological problems need to be treated, as well as any medical problems the bulimia may have caused. The combination of the following four treatments can be very effective in treating the individual with bulimia.

- Nutritional counseling teaches individuals when to eat and how much they should eat to maintain weight. Their diets should include a lot of nutrients, and sugar should be eliminated to help reduce binging. Other things that should be eliminated are alcohol, caffeine, things that enhance flavors, the majority of salt, and cigarettes. The diet should also be balanced and a multivitamin with minerals, along with 1000 milligrams of Vitamin C and 50 milligrams of Vitamin B complex should be taken daily.http://www.webmd.com/mental-health/bulimia-nervosa/understanding-bulimia-treatment

- Cognitive-behavioral therapy (CBT) is very effective in changing distorted thinking about food and the individuals that is a part of their compulsive behavior. It also helps them find better way to deal with stresses. Combined with medication it helps them deal with their psychological symptoms and help them to avoid relapse.http://www.health.harvard.edu/fhg/updates/treating-bulimia-nervosa.shtml

- Interpersonal therapy helps individuals deal with problems in their personal relationships which frees them up to work on their eating disorder.http://www.health.harvard.edu/fhg/updates/treating-bulimia-nervosa.shtml

- SSRIs - At this time the FDA has only approved Prozac for treating eating disorders. Limited research has been done on Zoloft and so far it has also been found to be effective for adults with eating disorders. Several SSRIs may have to be taken in a sequence until the correct one is found.http://www.health.harvard.edu/fhg/updates/treating-bulimia-nervosa.shtml Celexa and Lexapro have more recently been added as part of the SSRIs effective in treating bulimia.http://www.webmd.com/mental-health/bulimia-nervosa/understanding-bulimia-treatment Antidepressants or medications may be prescribed to treat bulimia. They can also help treat mental disorders that may accompany bulimia, such as depression or anxiety.http://www.mayoclinic.com/health/bulimia/DS00607/DSECTION=treatments-and-drugs

- Other therapies that are sometimes used are psychotherapy, where the individual is given a chance to talk about their condition and issues with a mental health provider, and family therapy which helps the family resolve conflicts and learn to be involved in making sure the individual is following healthy eating patterns and regaining weight. Family therapy can also encourage the family to support the individual in a productive manner.http://www.mayoclinic.com/health/bulimia/DS00607/DSECTION=treatments-and-drugs

- Hospitalization may be necessary in severe cases of bulimia where there are serious medical problems.http://www.mayoclinic.com/health/bulimia/DS00607/DSECTION=treatments-and-drugs

- Specialized eating disorder clinics may be offered on either an inpatient basis or as a day treatment program.http://www.mayoclinic.com/health/bulimia/DS00607/DSECTION=treatments-and-drugs

It is impossible for individuals to treat bulimia themselves. There are some steps they can take that, when added to their treatment plan, can increase the success of their recovery.

- Stick to the treatment plan. It is important for the individual to stick to their treatment plan. This includes attending therapy sessions and sticking to their meal plans even if they are not comfortable with it. It is important for the individual to maintain a healthy weight.

- Get the right nutrition. This is very important because purging causes the loss of nutrients that the body is receiving. Individuals with bulimia often do not eat well and in order to get healthy they need to provide their body with good nourishing foods or supplements.

- Learn about bulimia. Education is a key factor in empowering and motivating you to stick to the treatment plan in order to get healthy.

- Stay in touch. Often people with bulimia isolate themselves from those who care about them and want to see them healthy. Having people around you that care about you and want to nurture you is healthy in getting well.

- Be kind to yourself. Do not allow yourself to constantly look in the mirror or weigh yourself. This can rekindle the unhealthy habits you are trying to eliminate.

- Be cautious with exercise. If the individual was exercising excessively as part of their disorder, it is important to talk to the health care providers about what exercises they should be doing.http://www.mayoclinic.com/health/bulimia/DS00607/DSECTION=lifestyle-and-home-remedies

Alternative Treatments

- Herbal Teas. According to the University of Maryland Medical Center drinking two cups of herbal tea consisting of holy basil, milk thistle, grape seed, catnip or ashwagandha can be helpful in improving damage bulimic behaviors have done to the organs. A teaspoon of these herbs should be seeped in hot water for five to ten minutes. Labels should be checked for potency, but the best thing is to ask for guidance from someone who is qualified to give you instructions on the different herbs.

- Acupuncture. Patients with bulimia often experience anxiety and insomnia. Acupuncture is done by placing needles into certain parts of the body which produces a therapeutic effect. Although the treatment is not specific to bulimia, acupuncture was shown to reduce anxiety and insomnia which can help improve the overall health of the individual with bulimia. Seek guidance of a health professional before beginning acupuncture.

- St. John’s Wort. This plant has been used for centuries to treat anxiety and depression which are also part of the symptoms of bulimia. It has been shown to assist minimally in reducing symptoms of all types of depression. The National Center for Complementary and Alternative Medicine (NCCA) warns that it may cause interactions with other medications. Before adding it as a supplementary form of treatment, consult with a health care professional to make sure it is safe.http://www.livestrong.com/article/85689-alternative-medicines-treat-bulimia/

Good and Bad Alternatives

Bad alternatives:

Individuals with eating disorders often abuse dietary supplements and herbal products to help with weight loss. Caution must be taken because they may have dangerous interactions with medications like laxatives and diuretics that are often used by individuals with eating disorders. They can also have serious side effects like “irregular heartbeats, tremors, hallucinations, insomnia, nausea, dizziness and nervousness.” Be sure to check with a medical professional before using any of these weight-loss supplements or herbal products.http://www.mayoclinic.com/health/bulimia/DS00607/DSECTION=alternative-medicine

Good alternatives:

Yoga has not been extensively studied, but it may have some benefits for individuals with bulimia. It is good to help the person relax and have a sense of well being.http://www.mayoclinic.com/health/bulimia/DS00607/DSECTION=alternative-medicine

Long Term Outlook

Even though the outlook in the short term is not very encouraging, the outlook in the long term is much better. Studies ten years later show that individuals with bulimia who received treatment had a 70% recovery rate.

The content in this page is not a substitute for professional medical advice. If you think you suffer from bulimia, please consult your doctor or a mental health care professional.