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Do you or does someone you love struggle with Bulimia? If so, treatment is essential and effective – but when trying to figure out what you need; it can all get pretty confusing.

To help you gain a better understanding of how to approach the treatment of this eating disorder, here are ten treatment guidelines for bulimia nervosa from the U.K. National Collaborating Center for Mental Health. 

Although these treatment guidelines were produced for a professional audience they are clear and comprehensible enough for anyone to grasp and may help you to get your head around the necessary steps on the road to better health and wellness.

10 Steps to the Treatment of Bulimia Nervosa

1. As a possible first step, patients should be encouraged to participate in an evidence based self help program. With support and encouragement, some patients with bulimia may find that an evidence based self help program alone produces effective recovery and remission.

2. Patients with bulimia should also be encouraged to get cognitive behavioral therapy for bulimia nervosa (CBT – BN), which is a form of cognitive behavioral therapy which is specifically designed to treat people with this eating disorder. An average course of treatment with CBT – BN consists of 16 to 20 sessions over a 4 or 5 month period.

3. If cognitive behavioral therapy (CBT) doesn’t work (or if people do not want CBT) then other forms of therapy should be suggested.

4. Interpersonal therapy is another effective treatment for bulimia, but patients should be informed that gains are typically made more slowly in interpersonal therapy than in CBT –BN. A typical course of interpersonal therapy for bulimia will proceed over 8 to 12 months.

5. Medications may also be considered as an alternative or complementary first step along with or instead of participation in an evidence based self help program.

6. Only antidepressants are effective in the treatment of bulimia nervosa. The most commonly used antidepressants are from the SSRI family. Antidepressants can reduce binging and purging behaviors.

7. Patients who have been purging heavily with laxatives or through vomiting may need to have their electrolyte balance checked. In most cases, reducing the purging behaviors is sufficient to restore an electrolyte balance, although a small percentage of patients may need medical intervention to restore balance.

8. The great majority of patients with bulimia can be treated on an outpatient basis.

9. Inpatient treatment may be necessary for patients at risk of self harm behaviors or those with suicidal thoughts or intentions. If inpatient care is warranted it should occur at a facility which specializes in treating eating disorders.

10. Patients with bulimia may also present with substance abuse problems. People with substance abuse problems are less likely to respond well to a standard program of care and treatment should be adapted to match the situation of the individual patient.1

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Page last updated Jun 24, 2012

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