A Brief Guide to Treatment for Bulimia Nervosa
What is bulimia?
Bulimia nervosa is a serious mental health disorder that carries many significant health risks. It consists of an individual bingeing on a large amount of food in a short period of time, coupled with purging, whether that is self-induced vomiting, excessive exercise, and/or laxative abuse. Those who find themselves bingeing on a regular basis may eat in secret due to feeling intense shame or a lack of control. It is important to remember that recovery is possible for those who struggle with bulimia, and getting support can mitigate or minimize the health risks that come with it.
What are the risks?
Due to the nature of the disorder, bulimia has the potential to bring significant health risks from very early on in the initiation of behaviors. Risks include, but are not limited to, tooth decay, gastrointestinal distress, electrolyte imbalances, heart arrhythmias, and even death.
What does treatment look like?
Treatment for bulimia is multifaceted and is comprised of a multidisciplinary team to address the emotional, physical, and mental concerns that accompany the disorder.
-Therapist: A therapist can support the individual by exploring the personal and interpersonal impacts of the eating disorder while creating strategies for a more balanced life. Topics discussed can include body image, warning signs and triggers for bingeing and purging, and the recovery process.
-Dietitian: A dietitian can support with the nutritional aspect of the disorder, providing education, meal support, other aspects of nutrition guidance. A dietitian might challenge thoughts and beliefs about certain foods while addressing GI concerns, building support for family meals, or correcting nutritional deficiencies.
-Doctor: A doctor can medically monitor the individual struggling, ordering tests and checking on medical stability, given the significant health risks.
-Psychiatrist: There are certain medications that have been proven effective in the treatment of bulimia nervosa, and a psychiatrist or psychiatric nurse practitioner can prescribe these mediations and monitor their efficacy.
-Dentist: The dentist is an important but often forgotten part of the team, as they can address potential enamel loss, carries, or other damage from self-induced vomiting in addition to supporting with minimizing future loss.
When might someone need a higher level of care?
It is important to consider an individual’s current symptoms and needs when beginning treatment for bulimia nervosa. An outpatient setting, meaning meeting with treatment providers on a regular basis while still attending to other responsibilities, can be a helpful way to address therapeutic goals.
However, there are times where a higher level of care could be warranted, such as intensive outpatient (IOP), partial hospitalization (PHP), residential (RTC), or inpatient hospitalization (IP). When considering which level of care is warranted, the American Psychiatric Association has a list of guidelines that can point one in the right direction. These guidelines take into consideration whether one can eat independently, how frequently behaviors are happening, if there are other mental health struggles present, etc. Higher levels of care have a range in time commitment and intensity; IOP is usually 3 hours a day, 5 days a week with group therapy, individual therapy, meal support, dietary support, and medication management, whereas inpatient hospitalization is more medically based with little to no therapeutic support.
What does treatment look like at Brown Family Counseling?
Treatment for bulimia is tailored to each individual client, with options to integrate modalities such as CBT, DBT, brainspotting, and animal-assisted therapy. Therapy is client-led, which means the client determines the pace. We tackle topics such as body image, shame and guilt, how to cope during difficult situations, and more. If you would like more information on treatment for bulimia, reach out today for a free 15 minute consultation call.