Bulimia (cont.)

Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What is bulimia?
• What causes bulimia?
• How is bulimia diagnosed?
• What are signs that may suggest a person has bulimia?
• What medical complications and long-term effects can bulimia have?
• How is bulimia treated?
• Bulimia At A Glance
• Patient Comments: Bulimia - Describe Your Experience
• Patient Comments: Bulimia - Treatment
• Find a local Psychiatrist in your town
• Bulimia Index

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.