How is bulimia treated?

The goal of treatment is to break the pattern of binge-purge behavior, correct distorted thinking patterns, and develop long-term behavioral changes. Your treatment team may consist of medical doctors, dietitians, and mental health professionals.

Typical treatment consists of medications plus psychological counseling and nutritional counseling. Medications common used include selective serotonin reuptake inhibitors such fluoxetine (Prozac®) or sertraline (Zoloft®); atypical neuroleptics such as olanzapine (Zyprexa®) and serotonin-norepinephrine reuptake inhibitors. Tricycylic antidepressants are less likely to be used as they may cause cardiac rhythm abnormalities

Psychological counseling is a type of individual counseling that focuses on changing the thinking (cognitive therapy) and behavior (behavioral therapy) of a person with an eating disorder. Treatment includes practical techniques for developing healthy attitudes toward food and weight, as well as approaches for changing the way the person responds to difficult situations. Three types of psychotherapy are thought to be the most helpful for treating bulimia. These are:

  • Cognitive Behavioral Therapy (CBT). This therapy’s goal is to address distorted views and attitudes about weight, shape and appearance and practice behavioral modification (if “X” happens, I can do “Y” instead of “Z”).
  • Dialectical Behavior Therapy (DBT), is CBT plus insight. In other words, this therapy helps the individual not just develop new skills to handle negative triggers, but also helps the person develop insight to recognize triggers or situations where a non-useful behavior might occur. Specific skills include building mindfulness, improving relationships through interpersonal effectiveness, managing emotions and tolerating stress.
  • Family-based Treatment (also called the Maudsley Method). This therapy involves family-based feeding, which means putting the parents/family in charge of getting the appropriate nutritional intake consumed by the individual with the eating disorder. FBT has shown more efficacy with anorexia nervosa at this time, with studies ongoing.

Nutrition counseling involves learning healthier way to eat under the guidance of a registered dietitian or counselor.

Last reviewed by a Cleveland Clinic medical professional on 12/12/2019.

References

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