How to Overcome Bulimia

Co-authored by Amy Chow

Last Updated: December 23, 2023 References

Do you think you may suffer from the eating disorder bulimia nervosa? Are these food issues interfering with your life? An estimated 4% of women in the United States will suffer from bulimia during their life,^{[1]
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PubMed Central
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Go to source} and only 6% will receive treatment. If you think you have bulimia or if you are looking for treatment help, there are options you can explore.

Part 1

Part 1 of 3:

Helping Yourself Overcome Bulimia

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1
Discover if you have bulimia. Self-diagnosis of psychiatric conditions is inadvisable. If you suspect that you may need help, please consult your medical professional, especially if you meet the following criteria:^{[2]
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Mayo Clinic
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- Binge-eating, or consuming larger amounts of food at a time than is normal.
- Feeling a lack of control over this binging.
- Purging and other methods of preventing weight gain, such as vomiting, using laxatives/diuretics to compensate for the overeating, fasting, or excessive exercising. People with bulimia do this at least once a week for three months.
- Body image issues, where your self-esteem is defined disproportionately by how you look (weight, shape, et cetera) compared to other factors.
2
Identify your triggers. If you want to increase awareness surrounding the condition, try to discover your emotional triggers. These triggers are events and situations that push your emotional buttons and cause you to want to binge and purge. Once you know what they are, you can avoid them if possible, or at least try approaching them differently. A few common triggers are:^{[3]
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- Negative perceptions toward your body. Do you look in the mirror and experience negative thoughts and emotions about your appearance?
- Interpersonal stress. Does fighting with a parent, sibling, friend, or romantic partner make you want to engage in bulimic activity?
- Negative mood states more generally. Anxiety, sadness, frustration, and others can precipitate the desire to binge and purge.
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3
Research intuitive eating. Traditional dietary programs are not usually effective for eating disorders and can actually exacerbate symptoms. However, intuitive eating can help you to reorganize your relationship with food. Intuitive eating is a method of learning to listen to and honor your body developed by dietitian Evelyn Tribole and nutrition therapist Elyse Resch.^{[4]
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PubMed Central
Journal archive from the U.S. National Institutes of Health

Go to source} It can help with:
- Developing interoceptive awareness. Interoception is your ability to perceive what is going on inside your body; it's a must for creating a healthier knowledge of what your body wants and needs. Deficiencies in interoception may correlate with eating disorders.^{[5]
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  Go to source}
- Gaining self-control. Intuitive eating is associated with decreased disinhibition, loss of control, and binging.
- Feeling better overall. Intuitive eating is also associated with general improvements in well-being: less preoccupation with body issues, higher self-esteem, and more.
4
Keep a journal. Keeping a bulimia-related journal will help you stay on top of what and when you're eating, what is triggering your eating disorder symptoms, and can also serve as an expressive outlet for your feelings.^{[6]
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- Writing in your journal at the end of each day will help you check-in with yourself and become more aware of how you're feeling regarding your meals.
Don't overstock on groceries, so that you won't have as much opportunity to binge. Plan ahead and carry as little money as possible. If someone else does your shopping, such as a parent, ask them to take your dietary needs into consideration.
6
Plan your meals. Aim for three or four meals and two snacks; schedule them at particular times of the day, so that you know when you will be eating and can restrict yourself to those predetermined sets of times. Develop this as a routine to keep yourself one step ahead of the impulsive behavior.^{[7]
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- For balanced meals, focus on eating at least 3 food groups. As for the snacks, aim to eat at least 2 food groups.

Part 2

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Enlisting Help from Professionals and Peers

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1
Seek therapy. Therapeutic interventions such as cognitive-behavioral therapy and interpersonal therapy have shown to aid in recovery, with long-lasting effects. Use psychologytoday.com to find a therapist near you who specializes in these models. A dietitian or counselor trained in eating disorders can be really good support to help you navigate the medical system and start getting professional help.^{[8]
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National Health Service (UK)
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- Cognitive-behavioral therapy seeks to restructure your thoughts and behaviors so that self-destructive tendencies rooted in these aspects will be replaced by healthier modes of thinking and behaving. If you binge and purge because of deeply rooted beliefs about yourself, as many people do, CBT can help rework the ground level of those thoughts and expectations.
- Interpersonal therapy focuses on relationships and personality structure rather than more clearly defined thought patterns and behaviors,^{[9]
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  PubMed Central
  Journal archive from the U.S. National Institutes of Health
  
  Go to source} so it may be more effective if you want less pointed behavioral instructions or thought-restructuring, and want to focus more on your relationships with family, friends, and even yourself.
- Therapeutic alliance is one of the most important factors in the effectiveness of therapy, so be sure to find a therapist you can work with. This may take a little "shopping around" until you find someone you feel comfortable confiding in, but it can mean the difference between recovery or relapse, so don't settle!
2
Explore medication options. In addition to therapy, certain psychiatric medications can help with the treatment of bulimia. The primary class of drugs recommended for eating disorders is antidepressants, especially SSRIs such as fluoxetine (Prozac).^{[10]
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National Health Service (UK)
Public healthcare system of the UK

Go to source}
- Ask your family doctor or psychiatrist about antidepressant medication options for bulimia.
- Medication is most effective for some mental conditions when combined with therapy rather than taken alone.
3
Join a support group. Although there's not a lot of research data on the effectiveness of joining support groups for eating disorders, some people do report groups such as Overeaters Anonymous to be useful for a secondary treatment option.^{[11]
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- Use this website to find a support group near you: click here.
4
Consider in-patient treatment. For serious cases of bulimia, consider pursuing inpatient treatment at a mental health facility. This will give you access to greater levels of medical and psychiatric care, as compared to self-guided methods, outpatient therapy, or support groups. You may need in-patient treatment if:
- Your health is deteriorating or your life is threatened as a result of bulimia.
- You've tried other methods of treatment in the past and have relapsed.
- You have additional health complications such as diabetes.
5
Look up recovery websites. Many people use internet forums for support during eating disorder recovery. These websites can be an important source of interpersonal support, allowing those suffering from these conditions to discuss the specific difficulties of living with eating disorders with people who are experiencing similar struggles.^{[12]
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Research source} Here are a few websites you may want to look at:
- Bulimiahelp.org Forum.
- National Association of Anorexia Nervosa and Associated Disorders Forum.

Part 3

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Enlisting Help from Family and Friends

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Research suggests that family support can play a major role in the recovery process.^{[13]
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Research source} In order to give yourself the best possible chance of recovery, educate your family and close friends about the condition. This will cultivate a social environment where healing can begin to take place. Use websites like Brown University's health education center^{[14]
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Ask your local university, hospital, or mental health clinic for information on bulimia-centered educational events. These events will help those close to you discover how they can be of service during your recovery process. They will learn healthy communication techniques as well as general information about bulimia nervosa.
3
Be clear about your needs. Family and friends may want to support you, but they may not have a clear picture of how to do that. Let them help by being clear about what you need from them. If you have particular dietary concerns, or if you feel judged about your eating activities, communicate these issues!
- Some research links bulimia to parenting styles that are rejecting, ambivalent, or over-involved. If your parents exhibit these styles, talk to them about what you feel you aren't getting, or are getting too much of in terms of attention. If your dad hovers around you all the time when you are eating, tell him that you appreciate the concern, but the over-involvement is actually making you feel more negatively about yourself and your behaviors.
- Research also suggests that in many families where eating disorders arise, communication can be discounted or ignored. If you feel like you aren't being heard, bring this up in an assertive but nonjudgmental way. Tell your mom or dad that you need to tell them something important and you are worried that it won't be heard. This will bring them into your concerns and help them understand where you are coming from.
Research shows that people who eat at least three meals per week with their family are significantly less likely to engage in eating disorder behavior.
Family-based treatment is an evidence based model involving family members in the therapeutic process. Research shows that it is effective for use with adolescents, potentially moreso than individualized therapy.^{[15]
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Bulimia has high rates of relapse^{[16]
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Warnings

Bulimia can lead to many dangerous health issues, such as lack of nutrition, hair loss, teeth erosion, erupted esophagus, and even death^{[17]
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