Bulimia (cont.)
How is bulimia treated?
Patients with bulimia present a variety of medical and psychological
complications which are usually considered to be reversible through a
multidisciplinary treatment approach. Treatment can be managed by either a
physician, psychiatrist, or in
some cases, a clinical psychologist. The extent of the medical complications
generally dictates the primary treatment manager. A
psychiatrist, with both medical and psychological training, is perhaps the
optimum treatment manager.
A number of antidepressant
medications have been shown to be beneficial in the treatment of bulimia.
Several studies have demonstrated that fluoxetine (Prozac), a member of the
selective serotonin reuptake inhibitor (SSRI) class of antidepressants, has been effective in the
treatment of bulimia. And the U.S. Food and Drug Administration has approved
fluoxetine for the treatment of bulimia.
Other types of antidepressants, including the monoamine
oxidase inhibitors (MAOIs), tricyclic antidepressants, and buspirone (Buspar)
have all been shown to decrease bingeing and vomiting in people suffering from
bulimia. However, the SSRIs remain the first choice for treatment due to their
relative safety and low incidence of side effects.
Other
drugs are currently under investigation as possible treatments for bulimia.
Examples are the antiepileptic drug topiramate and the serotonin antagonist
ondansetron.
Some patients may require hospitalization due to the
extent of the medical or psychological complications. Others may seek outpatient
programs. Still others may require only weekly counseling and monitoring by a
practitioner. Stabilization of the patient's physical condition will be the
immediate goal if the individual is in a life-threatening state. The primary
goals of treatment should address both physical and psychological needs of the
patient in order to restore physical health and normal eating patterns. The
patient needs to identify internal feelings and distorted beliefs that led to
the disorder initially. An appropriate treatment approach addresses underlying
issues of control, self-perception, and family dynamics. Nutritional education
and behavior management provides the patient with healthy alternatives to weight
management. Group counseling or support groups can assist the patient in the
recovery process as well.
The ultimate goal should be for the patient to accept
herself/himself and lead a physically and emotionally healthy life. Restoration of
physical and mental health will probably take time, and results will be gradual.
Patience is a vital part of the recovery process. A positive attitude coupled
with much effort on the part of the affected individual is another integral
component to a successful recovery.
- Bulimia (also called bulimia nervosa) is a
psychological eating disorder.
- Bulimia is felt to be related to a person's
dissatisfaction with their own body image, although the exact cause is not known.
- Bulimia is diagnosed according to defined
criteria.
- There are two types of bulimia: the purging and
nonpurging types.
- The purging type regularly engages in self-induced
vomiting or the misuse of laxatives, diuretics, or enemas.
- The nonpurging type engages in other inappropriate
behaviors such as fasting or excessive exercise, rather than purging.
- Bulimia can have serious medical complications.
- The successful treatment of bulimia is often
multidisciplinary involving both medical and psychological approaches.
- The goals of treatment are to
restore physical health and normal eating patterns.
Last Editorial Review: 3/28/2008
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