How to cure bulimia
Bulimia nervosa - Diagnosis and treatment
Diagnosis
If your primary care provider suspects you have bulimia, he or she will typically:
- Talk to you about your eating habits, weight-loss methods and physical symptoms
- Do a physical exam
- Request blood and urine tests
- Request a test that can identify problems with your heart (electrocardiogram)
- Perform a psychological evaluation, including a discussion of your attitude toward your body and weight
- Use the criteria for bulimia listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association
Your primary care provider may also request additional tests to help pinpoint a diagnosis, rule out medical causes for weight changes and check for any related complications.
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- Electrocardiogram (ECG or EKG)
- Urinalysis
- X-ray
Treatment
When you have bulimia, you may need several types of treatment, although combining psychotherapy with antidepressants may be the most effective for overcoming the disorder.
Treatment generally involves a team approach that includes you, your family, your primary care provider, a mental health professional and a dietitian experienced in treating eating disorders. You may have a case manager to coordinate your care.
Here's a look at bulimia treatment options and considerations.
Psychotherapy
Psychotherapy, also known as talk therapy or psychological counseling, involves discussing your bulimia and related issues with a mental health professional. Evidence indicates that these types of psychotherapy help improve symptoms of bulimia:
- Cognitive behavioral therapy to help you normalize your eating patterns and identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones
- Family-based treatment to help parents intervene to stop their teenager's unhealthy eating behaviors, to help the teen regain control over his or her eating, and to help the family deal with problems that bulimia can have on the teen's development and the family
- Interpersonal psychotherapy, which addresses difficulties in your close relationships, helping to improve your communication and problem-solving skills
Ask your mental health professional which psychotherapy he or she will use and what evidence exists that shows it's beneficial in treating bulimia.
Medications
Antidepressants may help reduce the symptoms of bulimia when used along with psychotherapy. The only antidepressant specifically approved by the Food and Drug Administration to treat bulimia is fluoxetine (Prozac), a type of selective serotonin reuptake inhibitor (SSRI), which may help even if you're not depressed.
Nutrition education
Dietitians can design an eating plan to help you achieve healthy eating habits to avoid hunger and cravings and to provide good nutrition. Eating regularly and not restricting your food intake is important in overcoming bulimia.
Hospitalization
Bulimia can usually be treated outside of the hospital. But if symptoms are severe, with serious health complications, you may need treatment in a hospital. Some eating disorder programs may offer day treatment rather than inpatient hospitalization.
Treatment challenges in bulimia
Although most people with bulimia do recover, some find that symptoms don't go away entirely.
Periods of bingeing and purging may come and go through the years, depending on your life circumstances, such as recurrence during times of high stress.
If you find yourself back in the binge-purge cycle, follow-up sessions with your primary care provider, dietitian and/or mental health professional may help you weather the crisis before your eating disorder spirals out of control again. Learning positive ways to cope, creating healthy relationships and managing stress can help prevent a relapse.
If you've had an eating disorder in the past and you notice your symptoms returning, seek help from your medical team immediately.
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- Cognitive behavioral therapy
- Family therapy
- Psychotherapy
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Lifestyle and home remedies
In addition to professional treatment, follow these self-care tips:
- Stick to your treatment plan.
Don't skip therapy sessions and try not to stray from meal plans, even if they make you uncomfortable. - Learn about bulimia. Education about your condition can empower you and motivate you to stick to your treatment plan.
- Get the right nutrition. If you aren't eating well or you're frequently purging, it's likely your body isn't getting all of the nutrients it needs. Talk to your primary care provider or dietitian about appropriate vitamin and mineral supplements. However, getting most of your vitamins and minerals from food is typically recommended.
- Stay in touch. Don't isolate yourself from caring family members and friends who want to see you get healthy. Understand that they have your best interests at heart and that nurturing, caring relationships are healthy for you.
- Be kind to yourself. Resist urges to weigh yourself or check yourself in the mirror frequently.
These may do nothing but fuel your drive to maintain unhealthy habits. - Be cautious with exercise. Talk to your primary care provider about what kind of physical activity, if any, is appropriate for you, especially if you exercise excessively to burn off post-binge calories.
Alternative medicine
Dietary supplements and herbal products designed to suppress the appetite or aid in weight loss may be abused by people with eating disorders. Weight-loss supplements or herbs can have serious side effects and dangerously interact with other medications.
Weight-loss and other dietary supplements don't need approval by the Food and Drug Administration (FDA) to go on the market. And natural doesn't always mean safe. If you choose to use dietary supplements or herbs, discuss the potential risks with your primary care provider.
Coping and support
You may find it difficult to cope with bulimia when you're hit with mixed messages by the media, culture, coaches, family, and maybe your own friends or peers.
So how do you cope with a disease that can be deadly when you're also getting messages that being thin is a sign of success?
- Remind yourself what a healthy weight is for your body.
- Resist the urge to diet or skip meals, which can trigger binge eating.
- Don't visit websites that advocate or glorify eating disorders.
- Identify troublesome situations that trigger thoughts or behaviors that may contribute to your bulimia, and develop a plan to deal with them.
- Have a plan in place to cope with the emotional distress of setbacks.
- Look for positive role models who can help boost your self-esteem.
- Find pleasurable activities and hobbies that can help distract you from thoughts about bingeing and purging.
- Build up your self-esteem by forgiving yourself, focusing on the positive, and giving yourself credit and encouragement.
Get support
If you have bulimia, you and your family may find support groups helpful for encouragement, hope and advice on coping.
Group members can truly understand what you're going through because they've been there. Ask your doctor if he or she knows of a group in your area.
Coping advice for parents
If you're the parent of someone with bulimia, you may blame yourself for your child's eating disorder. But eating disorders have many causes, and parenting style is not considered a cause. It's best to focus on how you can help your child now.
Here are some suggestions:
- Ask your child what you can do to help. For example, ask if your teenager would like you to plan family activities after meals to reduce the temptation to purge.
- Listen. Allow your child to express feelings.
- Schedule regular family mealtimes. Eating at routine times is important to help reduce binge eating.
- Let your teenager know any concerns you have. But do this without placing blame.
Remember that eating disorders affect the whole family, and you need to take care of yourself, too.
If you feel that you aren't coping well with your teen's bulimia, you might benefit from professional counseling. Or ask your child's primary care provider about support groups for parents of children with eating disorders.
Preparing for your appointment
Here's some information to help you get ready for your appointment, and what to expect from your health care team. Ask a family member or friend to go with you, if possible, to help you remember key points and give a fuller picture of the situation.
What you can do
Before your appointment, make a list of:
- Your symptoms, even those that may seem unrelated to the reason for your appointment
- Key personal information, including any major stresses or recent life changes
- All medications, vitamins, herbal products, over-the-counter medications or other supplements you're taking, and their dosages
- Questions to ask your doctor, so you can make the most of your time together
Some questions to ask your primary care provider or mental health professional include:
- What kinds of tests do I need? Do these tests require any special preparation?
- What treatments are available, and which do you recommend?
- Is there a generic alternative to the medicine you're prescribing for me?
- How will treatment affect my weight?
- Are there any brochures or other printed material I can have? What websites do you recommend?
Don't hesitate to ask other questions during your appointment.
What to expect from your doctor
Your primary care provider or mental health professional will likely ask you a number of questions. He or she may ask:
- How long have you been worried about your weight?
- Do you think about food often?
- Do you ever eat in secret?
- Have you ever vomited because you were uncomfortably full?
- Have you ever taken medications for weight loss?
- Do you exercise? If so, how often?
- Have you found any other ways to lose weight?
- Are you having any physical symptoms?
- Have any of your family members ever had symptoms of an eating disorder, or have any been diagnosed with an eating disorder?
Your primary care provider or mental health professional will ask additional questions based on your responses, symptoms and needs. Preparing and anticipating questions will help you make the most of your appointment time.
By Mayo Clinic Staff
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Treatment - Bulimia - NHS
Treatment may take time, but you can recover from bulimia.
Treatment for bulimia is slightly different for adults and those under 18 years old.
Treatment for adults
Guided help
You will probably be offered a guided self-help programme as a first step in treating your bulimia. This often involves working through a self-help book combined with sessions with a healthcare professional, such as a therapist.
These self-help books may take you through a programme that helps you to:
- Monitor what you are eating – this can help you notice and try to change patterns in your behaviour.
- Make realistic meal plans – planning what and when you intend to eat throughout the day can help you regulate your eating, prevent hunger and reduce binge eating.
- Learn about your triggers – this can help you to recognise the signs, intervene and prevent a binge-purge cycle.
- Identify the underlying causes of your disorder – this means you can work on those issues in a healthier way.
- Find other ways of coping with your feelings.
Joining a self-help support group, like one of the Beat online support groups for people with bulimia, may be helpful to you.
If self-help treatment alone is not enough or has not helped you after 4 weeks, you may also be offered cognitive behavioural therapy (CBT) or medicine.
Cognitive behavioural therapy (CBT)
If you are offered CBT, it will usually involve up to 20 sessions across 20 weeks.
CBT involves talking to a therapist, who will help you explore emotions and thoughts that could be contributing to your eating disorder, and how you feel about your weight and body shape.
They will help you to adopt regular eating habits and show you how to stick to them.
They should also show you ways to manage difficult feelings and situations to stop you from relapsing once your therapy ends.
Treatment for children and young people
Family therapy
Children and young people will usually be offered family therapy. This involves you and your family talking to a therapist, exploring how bulimia has affected you and how your family can support you to get better.
You may also be offered CBT, which will be the same as the CBT offered to adults.
Looking after yourself
It's important to look after your health while recovering from bulimia.
If you are vomiting regularly, the acid in your vomit can damage your teeth over time. In order to minimise this damage you should:
- avoid brushing teeth immediately after vomiting so you do not wear away the enamel
- rinse your mouth with a non-acidic mouthwash
- make sure you see your dentist regularly
- do not drink or eat acidic foods, such as fruit juice, during a binge and after purging
- do not smoke
Vomiting can also lead to risk of dehydration.
To avoid this, make sure you drink plenty of fluids to replace what you have vomited.
Medicine
Antidepressants should not be offered as the only treatment for bulimia. But you may be offered an antidepressant, such as fluoxetine (Prozac), in combination with therapy or self-help treatment, to help you manage other conditions, such as:
- anxiety or depression
- social phobia
- obsessive compulsive disorder (OCD)
Antidepressants are rarely prescribed for children or young people under 18.
Where treatment will happen
Most people with bulimia will be able to stay at home during their treatment. You'll usually have appointments at your clinic and then be able to go home.
However, you may be admitted to hospital if you have serious health complications, including:
- being very underweight
- problems with your heart
- being very ill and your life being at risk
- being under 18 and your doctors believing you do not have enough support at home
- doctors being worried that you might harm yourself or are at risk of suicide
Your doctors will keep a very careful eye on your weight and health if you're being cared for in hospital.
They will help you to reach a healthy weight gradually, and either start or continue any therapy you're having.
Once they are happy with your weight, as well as your physical and mental health, you should be able to return home.
Further support for bulimia
There are many organisations that support people with bulimia and their families, including:
- Anorexia & Bulimia Care
- Beat: beating eating disorders
- Mental Health Foundation
- Mind: for better mental health
Page last reviewed: 10 November 2020
Next review due: 10 November 2023
signs, symptoms, causes, diagnosis and treatment of the disease
The information provided on this page should not be used for self-treatment or self-diagnosis.
If you suspect a disease, you should seek help from a qualified specialist. Only your doctor can diagnose and prescribe treatment.
- Causes
- Symptoms of bulimia
- Classification
- Diagnostics
- Treatment of bulimia
- Prophylaxis
What is bulimia?
Bulimia is a disease from the group of eating disorders. The main signs of bulimia are bouts of uncontrolled consumption of large amounts of food, followed by emptying of the stomach by artificial induction of vomiting.
The patient constantly overeats, after which he begins to feel guilty and tries to quickly cleanse the body in various ways (enemas, inducing vomiting, taking diuretics and laxatives). To reduce weight, people begin to torture themselves with heavy physical exertion and sit on strict diets.
Most often, the disease occurs in young girls aged 15-24 years, whose weight is in the normal range or slightly higher. Most patients are associated with areas that require weight control (gymnasts, runners, dancers, models).
The diagnosis is made by a psychotherapist by interviewing and examining the patient, using psychodiagnostic questionnaires. How to cure bulimia? The therapy of the disease is complex and includes diet therapy, antidepressants, psychotherapy Source:
Anorexia nervosa and bulimia nervosa: from history to the present. Barylnik Yu.B., Filippova N.V., Deeva M.A. Guseva M.A. Russian Psychiatric Journal No. 3, 2016. p. 36-45.
Causes
This mental disorder usually develops under the influence of social factors, which include:
- the imposition of artificial standards of beauty on the Internet, on television, in advertising;
- interpersonal contacts;
- excessive self-criticism resulting from the negative influence of someone close to you;
- low self-esteem, self-doubt;
- desire for ideal forms, excessive pedantry.
Bulimia nervosa is especially common in the EU and the US, where the fashion industry is well developed and the population is highly exposed to advertising, TV and the Internet.
In recent decades, bulimia is increasingly common in Russia.
But in the countries of Latin America or India, where beauty standards are different and "girls in the body" are valued, the number of patients with bulimia is extremely small.
There are a number of other factors that can trigger the development of the disease.
These include:
- hereditary predisposition;
- lack of serotonin in the body;
- depression;
- chronic stress;
- increased anxiety Source:
Modern ideas of young people about eating disorders (bulimia). E. M. Solodovnik, L. A. Nepovinnykh. International Journal of Humanities and Natural Sciences №42, 2020. p. 159-163.
Symptoms of bulimia
The main signs of the disease are:
- constant weight control, perception of oneself as a fat person, although in reality it is not, fear of gaining weight;
- uncontrollable, obsessive desire to eat;
- constant overeating - it can be objective, when the patient really eats too much food at a time and subjective, when the food is eaten a little, but the person thinks that he overeats, the frequency of such episodes in bulimia is at least twice a week for three months or more , after eating, the patient feels guilt, despair, anger;
- getting rid of food eaten by artificial methods to avoid weight gain (taking appetite suppressants, laxatives, inducing vomiting, cleansing enemas).
To confirm the diagnosis of bulimia, the patient must have all 4 of the above symptoms. The diagnosis is made by a psychiatrist after examination and detailed questioning of the patient.
In addition to the above signs, a person with bulimia feels loneliness, helplessness in front of his problem, he develops depression. As a result, in search of support, many people, instead of contacting a specialist, find thematic communities about bulimia and anorexia on the Internet and try to solve their problems on their own, which rarely gives a result. If bulimia is started, then over time this leads to metabolic disorders and the development of diseases of internal organs Source:
Overeating as a way to regulate the emotional sphere of people with cleansing bulimia nervosa syndrome. Svitkevich Yu.V. North Caucasian Psychological Bulletin No. 1, 2021. p. 5-20.
Classification
There are two types of bulimia:
- cleansing - after episodes of overeating, the patient tries to get rid of food by causing bouts of vomiting, enemas, taking laxatives and diuretics;
- non-cleansing - less common, in this case the patient tries to compensate for overeating with intense sports, fasting.
According to the nature of attacks, three types of disease are distinguished:
- paroxysmal - periods of overeating occur suddenly;
- nocturnal - attacks of gluttony and hunger occur exclusively at night, during the day the appetite is normal or reduced;
- constant - overeating is replaced by cleansing of the body, after which the patient soon begins to experience hunger again.
Diagnosis
Diagnosis is made by a psychotherapist based on anamnesis, questioning and examination of the patient, results of laboratory and instrumental studies. To determine the degree of metabolic disturbance, a blood test for biochemistry may be prescribed.
If there are indications for diagnosing disorders in the functioning of internal organs, the doctor may prescribe such examinations as ECG, CT, ultrasound and a number of others.
Treatment of bulimia
How to deal with bulimia? Treatment of the disease will include the following steps:
1.
Psychotherapy. Bulimia needs to be treated comprehensively. After all, this pathology leads not only to organic and functional disorders, but also to psychopathological consequences for health. Therefore, for those who are looking for ways to get rid of bulimia on their own, it is better not to waste time and immediately seek help from specialists. The main treatment for bulimia today is cognitive behavioral therapy. In addition, interpersonal therapy and cognitive-emotional therapy show good results. Children and adolescents are treated with systemic family therapy.
2. Medical treatment. To correct this pathological condition, the patient is prescribed antidepressants. This helps to quickly normalize the emotional background, reduce the strength and frequency of seizures, which, in combination with psychotherapy, gives good results. With properly selected treatment and patient compliance with all the recommendations of the attending physician, the prognosis is favorable.
3.
Nutrition. Patients need to eat varied, wholesome, do not overeat, do not starve, do not go on diets, refuse to take medications for weight loss.
Prevention
To prevent new attacks, the following preventive measures should be observed:
- improve the patient's self-esteem;
- create a healthy psychological environment in the family;
- set a person to positive thinking;
- create a stable and safe environment in the environment. Source:
Transactional analysis of bulimia in a passive-aggressive personality. Dmitrieva N.V., Krasovskaya N.R. Medical psychology in Russia No. 6, 2018. pp. 1-16.
It is necessary that the patient is clearly aware of his problems and understands that the struggle with them must continue until complete recovery. The most important preventive measure is the observance of the principles of rational and healthy nutrition.
Patients with a confirmed eating disorder (EDD) need to see a psychotherapist periodically.
The specialists of our clinic will help to cure the disease and avoid the severe consequences of bulimia.
You can make an appointment with a doctor right now by calling the indicated numbers or filling out the feedback form on the website.
- Anorexia nervosa and bulimia nervosa: from history to the present. Barylnik Yu.B., Filippova N.V., Deeva M.A. Guseva M.A. Russian Psychiatric Journal No. 3, 2016. p. 36-45
- Modern ideas of young people about eating disorders (bulimia). E. M. Solodovnik, L. A. Nepovinnykh. International Journal of Humanities and Natural Sciences №42, 2020. p. 159-163
- Overeating as a way to regulate the emotional sphere of people with purgative bulimia nervosa syndrome. Svitkevich Yu.V. North Caucasian Psychological Bulletin No. 1, 2021. p. 5-20
- Transactional analysis of bulimia in a passive-aggressive personality. Dmitrieva N.V., Krasovskaya N.R. Medical psychology in Russia No. 6, 2018. p.1-16
Article published : 10/12/2016
Last updated : 4/15/2022
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Treating bulimia at home
Oddly enough, most food addicts enter the phrase “how to deal with bulimia on your own” on the Internet, and not “how to cure bulimia on your own.” What is it: a mere coincidence or an intuitive analytical perception of reality? Is it possible to recover from bulimia on your own, or can you only fight it endlessly on your own?
I will try to remain neutral in this article, and find out how you can still treat bulimia at home.
The Psychology of Bulimia
It's no secret to most of you that food addiction comes from trying to improve your emotional state through food. But try to seriously think about exactly what feelings you are trying to “seize”, why suddenly food began to come first in your life. This did not happen in one moment, like a relationship with a loved one: everything does not collapse overnight.
This is the result of a whole string of certain interrelated actions. And can you independently analyze all your actions, change your habits, without leaving your comfort zone? For some reason, only in Russia, seeking help from specialists - psychologists, is considered something shameful, and thousands of people "heal" their psychological wounds on their own: in bars, clubs and restaurants, someone drinks, someone eats, someone then finds more potent "medicines".
Nutrition for bulimia
There are an endless number of dietary recommendations for bulimia. But the fact remains that if you fail to cope with the psychological component of food addiction, any diet or diet prescribed by a nutritionist will lead to another breakdown.
Diet is contraindicated in bulimia. The bulimic has already developed an unshakable dependence on a large amount of food - a symptom of overeating. And food restrictions will only lead to a worsening addiction. An irresistible desire to experience the whole gamut of tastes while eating will lead to a real state of withdrawal: food is a drug for a food addict.
For most bulimics, a zinc blood test usually shows insufficient levels of zinc in the body. Therefore, doctors often prescribe zinc-containing vitamin complexes, zinc-containing products that allegedly allow you to normalize taste buds and thus reduce the number of attacks of uncontrolled eating. However, as practice shows, you can try to maintain the normal functioning of the body of a bulimic in various ways, but only complex therapy can help cure bulimia, eliminate the consequences and help a person regain happiness in life.
Treatment of bulimia with folk remedies
Various herbal teas, herbal decoctions are certainly beneficial for the body. Green tea with mint calms the nervous system and tones up, helps to normalize the functioning of the heart and respiratory organs, which is why many food addicts love it so much. But all these "miracle" remedies will not help you cure bulimia. You can only reduce the symptoms for a while. But the uncontrollable hunger pangs of bulimia are not due to the natural needs of the body, and they cannot be controlled with food that satisfies hunger.
Naturally, one always wants to believe in a miracle: in traditional healers, in the power of religion, hypnosis and herbal infusions, magicians and sorcerers who, by magic, will save you from any troubles and hardships. But these are all just attempts to get away from reality, to switch to something else for a while, during this period a remission of the disease may occur. However, over time, with any stress, the symptoms of the disease will again make themselves felt, but with renewed vigor.
Treat folk methods of dealing with bulimia with extreme caution: along with banal advice to consume large amounts of water, drink kefir, there are also those that can harm your body. For example, various types of garlic "treatments" for bulimia may lead to gastrointestinal problems, rather than help you cope with bulimia.
To cure any disease at home is a completely natural desire of every person. This is not only evidenced by numerous studies that speak of self-medication as a national problem, but also by the facts: we all have headaches from time to time, our hearts ache, and with the hope that this is only a temporary ailment, we swallow another advertised miracle pill.
And we are happy to ignore the inscription on the package "consult a doctor before use."
Our negligent attitude towards our own health, our national “I'll be patient” sometimes leads to irreparable consequences. Therefore, after reading this article, do not forget that all methods and methods of treating bulimia are for informational purposes only. And try not to ignore the fact that eating disorders are diseases. But diseases are little known in Russia and the CIS countries. Therefore, if few people think of treating cancer or sore throat at home, then food addiction is easy.
And of course you would be right to ask: “How can I know if I have a sore throat, is it a sore throat or a common cold?”. But it's better to seek help from a doctor and find out than to live in ignorance, which can lead to irreparable consequences. Therefore, the choice is always yours: contact a specialist, or rely on the natural all-Russian "Maybe it will blow over."
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Most girls and women are captivated by stereotypes and in pursuit of an ideal appearance and figure are constantly trying to change themselves.
