The struggle with bulimia can feel like you’re trapped in a downward spiral with no way out. You may be deeply entrenched in bulimic behaviors, whether they include binging and self-induced vomiting, laxative or diuretic abuse, other drug abuse, fasting, or overexercising. You might feel out of control and trapped in a toxic cycle. Not only may your relationship with food and eating be dysfunctional, but your physical and psychological health can also begin to take a toll. Your job performance and relationships may also become unsteady as this disorder becomes consuming. When you are in such a desperate state, you may feel paralyzed about how to move forward. Fortunately, various types of help are available so you don’t have to battle bulimia on your own.
Comprehensive is Key
When fighting bulimia, the best treatment is a biopsychosocial approach. This means that all aspects of the individual’s health and functioning – biological/physical, psychological, and sociocultural should be addressed to make sure that the individual is receiving comprehensive care and addressing as many risk factors as possible. Moreover, such an approach ensures that the individual creates protective scaffolding in various parts of their life to help bolster their recovery.
An imperative part of bulimia treatment is to trace the psychological sources of these behaviors – these include emotional dysregulation, mental health history, the presence of comorbid mental disorders (depression, bipolar disorder, substance use, OCD, anxiety, personality disorders, etc.), a history of trauma, and relational stress. A therapist can help the client identify various triggers that may lead them to use bulimic behaviors and help the individual set up a plan to prevent behavioral relapse. Various styles of psychotherapy are available to address eating disorders. For instance, a therapist who practices cognitive behavioral therapy (CBT) can help the individual confront maladaptive thoughts, feelings and behaviors related to one’s bulimia. Motivational interviewing can be used to meet the individual where they are at in terms of whether or how much they want to change. Psychotherapy is also helpful in the individual’s development of adaptive coping skills for emotional regulation, and in helping the individual set up boundaries and create healthy social environments conducive to their recovery.
Meeting with a psychiatrist can help the individual address chemical, genetic, and biological forces of bulimia. Various psychotropic medications are prescribed for bulimia, particularly antidepressants. In fact, fluoxetine is indicated for the treatment of bulimia, and is the only medication specified for the treatment of any of the eating disorders (McElroy et al., 2015). Such medications can help with the ruminations, reward-seeking urges, impulsivity, and other psychological features that play into one’s bulimia. Moreover, these medications can also help treat comorbid disorders that may have preceded, occurred with, or resulted from the bulimia. Psychiatric treatment can prove to be helpful by bringing the individual to a more functional baseline so they are able to complete their therapeutic work and engage in other aspects of their treatment.
Nutritional: Since bulimia does include a dysfunctional relationship with eating patterns, nutritional counseling is an indispensable component of its treatment. A dietician can help the individual identify their body’s nutritional needs (i.e. types of nutrients, amount of food, allergies, etc.) and help create a plan for the individual to follow to get back into a regular eating routine. Such counseling can also be helpful in teaching the individual how to eat mindfully and intuitively – that is, based on their body’s natural hunger and fullness signals. Nutritional counseling can also help with educating the individual about what types of food are conducive to their body’s natural makeup as well as which can enhance their mental well-being.
Medical: Along with the psychological damage it causes, bulimia can have devastating physical effects on the body. The behaviors of bulimia can lead to gastrointestinal damage, heart complications, fluid and electrolyte imbalances, dental concerns, hormonal changes, kidney or immune system impairment, or skeletal abnormalities. Consulting with a physician is absolutely necessary to address such medical problems and prevent others from developing or exacerbating. Depending on the individual’s needs, the physician may need to help with stabilizing vital signs, abnormal laboratory findings, or other medical complications. As the individual tries to recover from bulimia, the physician can be necessary for addressing any gastrointestinal distress they may experience as their body adjusts to restoring normal eating patterns. Overall, medical help is essential to help monitor the individual’s physiological status and acute health risk.
Thus, a plethora of types of professionals exist to help you confront and recover from your bulimia.Meeting with one of these clinicians can open the doors to the others, as you can be provided with referrals for appropriate resources. The first step is to have the willingness to want to seek help.
Bahar Moheban, M.A. is a clinical psychology doctoral candidate and registered psychological assistant in Torrance under the supervision of Dr. Nazanin Moali. She provides individual therapy and facilitates a Body Image Group for adults and adolescents with disordered eating, body dissatisfaction, and comorbid disorders. If you are struggling with bulimia nervosa or any other type of disordered eating, contact Bahar for a counseling appointment to repair your relationship with food and body image.