Encyclopedia of Diets - A Guide to Health and Nutrition

binge/purge cycle, while others tend to reinforce the

behavior.

Drug therapy helps many people with bulimia.

Selective serotonin reuptake inhibitors (SSRIs) such

as fluoxetine (Prozac) and sertraline (Zoloft) have

been approved by the United States Food and Drug

Administration (FDA) for treatment of bulimia.

These medications increase serotonin levels in the

brain and are thought to affect the body’s sense of

fullness. They are used whether or not the patient

shows signs of depression. Drug treatment should

always be supplemented with psychotherapy. (see

Therapies below).

Other drugs are being explored for use in the

treatment of bulimia. Individuals with bulimia inter-

ested in entering a clinical trial at no cost can find a list

and description of clinical trials currently enrolling

volunteers at<http://www.clinicaltrials.gov>.

Nutrition/Dietetic concerns

A nutrition consultant or dietitian is part of the

team needed to successfully treat bulimia. These pro-

fessionals usually do a dietary review along with nutri-

tional counseling so that the recovering bulimic can

plan healthy meals and develop a healthy relationship

with food.

Therapy

Medical intervention helps alleviate the immedi-

ate physical problems associated with bulimia. Medi-

cation can help the person with bulimia break the

binge/purge cycle. However drug therapy alone rarely

produces recovery. Psychotherapy plays a major role

helping the individual with bulimia recover from the

disorder. Several different types of psychotherapy are

used depending on the individual’s situation. Gener-

ally, the goal of psychotherapy is help the individual

change his or her behavior and develop a healthy

attitude toward their body and food.

Some types of psychotherapy that have been suc-

cessful in treating people with bulimia are listed below.

Cognitive behavior therapy (CBT) is designed to

confront and then change the individual’s thoughts

and feelings about his or her body and behaviors

toward food, but it does not address why those

thoughts or feelings exist. Strategies to maintain

self-control may be explored. This therapy is rela-

tively short-term. CBT is often the therapy of choice

for people with bulimia, and it is often successful at

least in the short term.

Interpersonal therapy is short-term therapy that

helps the individual identify specific issues and prob-

lems in relationships. The individual may be asked to

look back at his or her family history to try to recog-

nize problem areas and work toward resolving them.

Interpersonal therapy has about the same rate of

success in people with bulimia as CBT.

Family and/or couples therapy is helpful in dealing

with conflict or disorder that may be a factor in

triggering binge/purge behavior at home.

Supportive-expressive therapy or group therapy may

be helpful in addition to other types of therapy.

Prognosis

The long-term outlook for recovery from bulimia

is mixed. About half of all bulimics show improvement

in controlling their behavior after short-term interper-

sonal or cognitive behavioral therapy with nutritional

counseling and drug therapy. However, after three

years, only about one-third are still doing well. Relap-

ses are common, and binge/purge episodes and

bulimic behavior often comes and goes for many

years. Stress seems to be a major trigger for relapse.

The sooner treatment is sought, the better the

chances of recovery. Without professional interven-

tion, recovery is unlikely. Untreated bulimia can lead

to death directly from causes such as rupture of the

stomach or esophagus. Associated problems such as

substance abuse, depression, anxiety disorders, and

poor impulse control also contribute to the death rate.

Prevention

Some ways to prevent bulimia nervosa from

developing are as follows:

If you are a parent, do not obsess about your own

weight, appearance, and diet in front of your

children.

Do not tease your children about their body shapes

or compare them to others.

Make it clear that you love and accept your children

as they are.

Try to eat meals together as a family whenever

possible.

Remind children that the models they see on tele-

vision and in fashion magazines have extreme, not

normal or healthy bodies.

Do not put your child on a diet unless advised to by

your pediatrician.

Block your child from visiting pro-bulimia Websites.

These are sites where people with bulimia give advice

Bulimia nervosa