Bulimia treatment basics
Bulimia is a mental health disorder that Right Diagnosis reports affects 1.5 million people in the United States. Often, bulimia develops after anorexia nervosa is already present. In fact, about half of all people who suffer from anorexia go on to develop bulimia or bulimic behavior patterns, the National Association of Anorexia Nervosa and Associated Disorders reports.
Signs and symptoms
Signs and symptoms of bulimia include:
- Frequent binge eating and overeating
- Eating in secret, including hiding food
- Going back and forth between overeating and fasting
- Going to the bathroom after eating
- Missing food
- Using laxatives, diuretics, etc.
- Extreme amounts of exercise
- Calluses or marks on the knuckles from using the fingers to induce vomiting
- Puffy cheeks
- Discolored or decaying teeth
- Being of normal weight or slightly overweight
- Weight that goes up and down
The disorder is often triggered by periods of binge eating that ensue after failed attempts at weight loss. For most, a level of emotional upset, disgust, and physical discomfort ensue after eating, instigating the purging period. For many, these feelings become pathological, so much so that some long-term bulimics will feel overly full and disgusted with their body after consuming only small amounts of food. Diagnosis is only rendered in patients who binge and purge two or more times a week for three months or longer.
Who is bulimic?
Certain individuals are more at risk for developing bulimia than others. Family history is known to contribute to the development of bulimia nervosa, so if an immediate family member has had it, you’re more likely to. The media and societal views of thin being “in” have been presumed to have a significant effect on the psyche and desire to be skinny, but a direct correlation between such and the development of bulimia has not been verified.
Bulimia is most commonly seen in adolescents and teens. Generally, this is the age range in which the disorder initially develops. The Bulimia Nervosa Resource Guide states that the disorder is less common in males, with 90 percent of its victims being females. Those with a pre-existing mental health disorder also have an increased risk of developing bulimia as compared to the general population. Comorbid disorders are common among the mentally ill. Among 282 females with bulimia and 97 with anorexia, 63.5 percent qualified for a lifetime anxiety disorder in one study reported by Eating Disorders Review.
Another study published in Psychological Medicine touted that 84 percent of bulimic females had a lifetime affective disorder, and 44 percent had a substance use disorder. Substance abusers are not new to comorbidity. In fact, the National Alliance on Mental Illness reports that 53 percent of all drug addicts and 37 percent of alcoholics have one or more serious mental health disorders.
Effects of bulimia
Prolonged bulimic behaviors can lead to severe bloating and weight gain, swelling of the extremities, pain in the abdomen, lethargy, dizziness, declining oral health, acid reflux, stomach ulcers, broken ocular blood vessels, swollen cheeks and salivary glands, a hoarse or raspy voice, a sore throat, persisting constipation, amenorrhea, and stomach or esophageal rupture.
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When substance abuse and bulimia are intertwined, treating both simultaneously will give the patient the best possible chance at a successful recovery from both disorders. Depending upon which substance you’ve been abusing, treatment varies. Some substances can complicate matters. For instance, stimulants are commonly abused by individuals with eating disorders as a way of staving off hunger. Adderall — an amphetamine-based drug prescribed for the treatment of attention deficit hyperactivity disorder — is a commonly abused substance among individuals with eating disorders. Around 36 percent of people taking Adderall claim to have experienced a reduced appetite as a result, and up to 11 percent actually lost weight.
Treating substance abuse always begins with detox. In 2001, 50 percent of patients who admitted themselves to detox completed the process, per the Substance Abuse and Mental Health Services Administration. From there, continued care is always encouraged.
Conjunctive treatment for bulimia can be tricky. Some bulimic patients will require residential care to enforce a proper diet and restrict the opportunity to binge and purge, but very few ever need to be hospitalized. TheHealthcare Cost and Utilization Project notes that rates of hospitalization are actually going down over recent years, reporting that hospitalizations with a principal diagnosis of eating disorder declined by 23 percent between 2007-2008 and 2008-2009.
The most common method of treatment for bulimia is psychotherapy. Among bulimia nervosa patients receiving medication or psychosocial treatment, 50 to 70 percent successfully reach remission, according to a review published in the Indian Journal of Psychiatry. Cognitive behavioral therapy and family therapy are the most widely prescribed methods, as is interpersonal psychotherapy, due to their repeated success. CBT is highly effective in training the patient to be more accepting of their body as it is and to adhere to a healthy and balanced diet moving forward.
The University of Chicago, Medicine notes that in one study of bulimic patients, 40 percent of those who had their family participate in treatment with them stopped binging and purging, whereas only 18 percent of those in the standard treatment group did such. Six months post-treatment, 30 percent of the family treatment group remained successful in abstaining from binging and purging, while only 10 percent of the other group did.PsychCentral attests that antidepressant medications can be helpful for some bulimic patients, noting Prozac’s efficacy in reducing binging episodes and calming the urge to vomit. Support groups are another great option for continued care beyond the professional treatment period.
Left untreated, bulimia does get worse and can be life-threatening. Among all patients with bulimia nervosa, up to 3 percent will die from it, according to a review published in the Primary Care Companion, Journal of Clinical Psychiatry. Combined, bulimia and substance abuse are a recipe for disaster. The chance of severe consequences and death rise with each passing day that you avoid getting help. There is a way out of this, and we can help. Call today to find out how.
Call for a free assessment. 352.771.2700