8
TREATMENT
Bulimia Nervosa
• Individuals with bulimia have frequent episodes of binge eating
that are followed by behaviors to try to prevent weight gain
from the binge-eating episode.
• Binges occur at least weekly and are typically secretive and
associated with feelings of shame or embarrassment. Behaviors
that follow binges can include purging through self-induced
vomiting, excessive exercising, or use of laxatives, diuretics (i.e.,
water pills), or other medications to influence weight.
• If untreated, bulimia can lead to physical complications
including esophageal tears, gastric rupture, and dangerous
cardiac arrhythmias.
• Treatment with cognitive-behavioral therapy (CBT) is
recommended for adults with bulimia.
• CBT focuses on examining and changing beliefs and behaviors
about food and weight. There can also be a focus on changing
beliefs that contribute to eating disorders such as perfectionism
and low-self-esteem.
• Family-based treatment is suggested for adolescent and young
adult patients with bulimia.
• In addition to psychotherapy, adults with bulimia may be
prescribed a type of medication called a serotonin reuptake
inhibitor (e.g., fluoxetine). When a serotonin reuptake inhibitor
is used, it can be started at the very beginning of treatment or
if there is minimal or no improvement after 6 weeks or more of
therapy alone.
