Eating Disorders Treatment How Bulimia Nervosa Is Treated By Julia Childs Heyl Julia Childs Heyl Julia Childs Heyl is a clinical social worker who focuses on mental health disparities, the healing of generational trauma, and depth psychotherapy. Learn about our editorial process Updated on August 11, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Rachel Goldman, PhD, FTOS Medically reviewed by Rachel Goldman, PhD, FTOS Facebook LinkedIn Twitter Rachel Goldman, PhD FTOS, is a licensed psychologist, clinical assistant professor, speaker, wellness expert specializing in eating behaviors, stress management, and health behavior change. Learn about our Medical Review Board Print SDI Productions / Getty Images Table of Contents View All Table of Contents Psychotherapy Medication Surgery and Invasive Procedures CAM & OTC Making Your Treatment Effective Bulimia is an eating disorder marked by a consistent pattern of binge eating and purging through the form of vomiting, overexercising, fasting, and laxative abuse. Bulimia Diagnosis To receive an official diagnosis of bulimia, the episodes of binging and purging must occur weekly for at least three months. This disorder typically begins to present itself in the pre-teen years and is most commonly diagnosed in females. However, males can also develop bulimia, and it is crucial to check for symptoms regardless of gender. Symptoms of bulimia are often somatic-based and result from the bodily trauma resulting from constant binging and purging. The most common symptoms include sore throat, sensitive teeth, worn tooth enamel, intestinal irritation, and severe dehydration. The most studied and recommended treatments include psychotherapy and medication. Mental health professionals can offer these two treatments in tandem in residential inpatient programs. However, other treatment options, including brain stimulation techniques and complementary treatment modalities, may not be discussed as often. This article will review each of these treatments in detail. Bulimia Nervosa and Your Teeth Psychotherapy Below discusses the types of therapy that can help treat bulimia. Cognitive-Behavioral Therapy Cognitive-behavioral therapy (CBT) is the preferred psychotherapy modality for those experiencing bulimia due to its strong evidence-based background. CBT is a form of talk therapy that supports patients in identifying negative thinking patterns and challenging these thought patterns to ultimately break maladaptive behavior and beliefs. CBT can curb the triggers associated with episodes of binging and purging, leading to a decreased likelihood of relapsing. Interpersonal Psychotherapy Interpersonal psychotherapy (IPT) is another recommended form of talk therapy. This brief evidence-based treatment explores social and interpersonal factors that prevent recovery from eating disorders. IPT will focus on the interpersonal stressors impacting the client that, in turn, lead to episodes of binging and purging. The aim of IPT is to encourage the individual to create lifestyle changes that are supportive of their recovery. Why CBT Is Usually Suggested for Eating Disorders Medication Medication may be prescribed to treat bulimia. Selective serotonin reuptake inhibitors (SSRIs) are the most effective in reducing symptoms. Common SSRIs include: Fluoxetine Citalopram Sertraline FDA-Approved Medication Fluoxetine, however, is the only bulimia medication that has received FDA approval. Topiramate is an anti-epileptic medication used off-label to treat bulimia. It has shown some success in minimizing binge episodes. Despite this success, it is important to note the side effects. For example, cognitive functioning impairment and weight loss can outweigh the benefits that taking this medication can bring. Treating Medical Complications Due to the nature of this disorder, medical complications tend to arise when treating bulimia. Dehydration is a common concern for those experiencing bulimia, for which saline in an IV drip is administered. Constipation can also result from excessive binging and purging or detoxing from laxatives. More holistic support like staying hydrated, getting some physical movement in, and eating dietary fiber will be suggested to maintain bowel regularity. What's An Eating Disorder? Surgery and Invasive Procedures While surgery and invasive procedures to treat bulimia are rare, they still exist. Below is one type of treatment that is sometimes used to treat bulimia. Deep Brain Stimulation Deep brain stimulation, a treatment that utilizes a surgically placed device to stimulate the brain, has been considered for treating bulimia. However, this therapy is still in its early stages, and while there is hope for this being a beneficial treatment, the clinical trials still leave much to be desired. What Are Compensatory Behaviors in People with Eating Disorders? Complementary Alternative Medicine (CAM) and Over-the-Counter (OTC) Some complementary alternative medicines can be quite supportive in treating bulimia. However, they must be used in addition to, not in place of, other forms of clinically-proven treatment. Yoga For example, a recent study shows that yoga can be quite helpful in treating some of the disturbances that trigger eating disorder episodes, like symptoms of anxiety, depression, and body image disturbance. In this study, no significant changes to body mass index were indicated, making yoga safe for those who need to gain weight. Other CAM Therapies The following CAM therapies require further research to prove efficacy, but they have potential: Massages and Bright Light Therapy: Often, depression can co-occur with bulimia, or some symptoms of depression may even trigger bulimic episodes. Tending to the depressive symptoms with massage and bright light therapy can help decrease the frequency of episodes. Acupuncture and Relaxation Therapy: For those who experience symptoms of anxiety alongside bulimia, acupuncture and relaxation therapy can be helpful. Similar to depression and bulimia, symptoms of anxiety can exacerbate bulimia. Soothing anxiety can, in turn, alleviate symptoms of bulimia. You Cannot Rely on CAM Therapies Alone Again, it is imperative to remember that these protocols will not work independently. A treatment plan including psychotherapy, medication, and lifestyle options will be needed in addition to complementary alternative medicine therapies to treat bulimia. Self-Help for Treating Your Eating Disorder How to Make Your Treatment Most Effective The most effective treatments include lifestyle changes, a robust support system, and a well-rounded treatment team. Moving through treatment for bulimia can be challenging, but recovery is possible. Here are some tips: Identify triggers and stressors: First, with the help of a licensed therapist, you'll consider the triggers you have in your life and assess how you can begin to shift them. Perhaps you have a negative relationship with a family member or find that a particular aspect of your life is incredibly stressful. Make lifestyle changes: Consider what changes can be implemented to minimize the harm to your mental and physical health. Exercising, and making a habit of journaling daily can help manage any intense emotions you might experience as you recover. Reach out to your support system: Allow yourself to lean on your friends and family. Also, ensure that medical professionals around you account for your mind-body-spirit wellness. Even though healing is hard, it can and will change the trajectory of your life. Your well-being is worth it. How Much Does Eating Disorder Treatment Cost? 7 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Jain A, Yilanli M. Bulimia nervosa. Treasure Island, FL. StatPearls Publishing; 2022. National Institute of Mental Health (NIMH). Eating disorders. Murphy R, Straebler S, Cooper Z, Fairburn CG. Cognitive behavioral therapy for eating disorders. Psychiatr Clin North Am. 2010;33(3):611-627. doi: 10.1016/j.psc.2010.04.004 Karam AM, Fitzsimmons-Craft EE, Tanofsky-Kraff M, Wilfley DE. Interpersonal psychotherapy and the treatment of eating disorders. Psychiatr Clin North Am. 2019;42(2):205-218. doi: 10.1016/j.psc.2019.01.003 Duriez P, Bou Khalil R, Chamoun Y, et al. Brain stimulation in eating disorders: state of the art and future perspectives. J Clin Med. 2020;9(8):2358. doi: 10.3390/jcm9082358 Fogarty, S, Smith, CA, Hay P. The role of complementary and alternative medicine in the treatment of eating disorders: A systematic review. Eating Behaviors. 2016;21:179-188. doi: 10.1016/j.eatbeh.2016.03.002 Hall A, Ofei-Tenkorang NA, Machan JT, Gordon CM. Use of yoga in outpatient eating disorder treatment: a pilot study. J. Eat. Disord. 2016;4(1):38. doi: 10.1186/s40337-016-0130-2 By Julia Childs Heyl Julia Childs Heyl, MSW, is a clinical social worker and writer. As a writer, she focuses on mental health disparities and uses critical race theory as her preferred theoretical framework. In her clinical work, she specializes in treating people of color experiencing anxiety, depression, and trauma through depth therapy and EMDR (eye movement desensitization and reprocessing) trauma therapy. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Eating Disorders Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.