Treatment for adults
You will probably be offered a guided self-help programme as a first step in treating your bulimia. This often involves working through a self-help book combined with sessions with a health care professional, such as a therapist.
These self-help books may take you through a programme that helps you to:
- Monitor what you are eating – this can help you notice and try to change patterns in your behaviour
- Make realistic meal plans – planning what and when you intend to eat throughout the day can help you regulate your eating, prevent hunger and reduce binge eating.
- Learn about your triggers – this can help you to recognise the signs, intervene and prevent a binge-purge cycle.
- Identify the underlying causes of your disorder – this means you can work on those issues in a healthier way.
- Find other ways of coping with your feelings.
Joining a self-help support group, like one of the Beat online support groups for people with bulimia, may be helpful to you.
If self-help treatment alone isn't enough or hasn't helped you after four weeks, you may also be offered cognitive behavioural therapy (CBT) or medication.
Cognitive behavioural therapy
If you are offered CBT, it will usually involve up to 20 sessions across 20 weeks.
CBT involves talking to a therapist, who will help you explore emotions and thoughts that could be contributing to your eating disorder, and how you feel about your weight and body shape.
They will help you to adopt regular eating habits and show you how to stick to them. They should also show you ways to manage difficult feelings and situations to stop you from relapsing once your therapy ends.
Treatment for children and young people
Children and young people will usually be offered family therapy. This involves you and your family talking to a therapist, exploring how bulimia has affected you and how your family can support you to get better.
You may also be offered CBT, which will be the same as the CBT offered to adults.
Looking after yourself
It's important to look after your health while recovering from bulimia.
If you are vomiting regularly, the acid in your vomit can damage your teeth over time. In order to minimise this damage you should:
- avoid brushing teeth immediately after vomiting so you don't wear away the enamel
- rinse your mouth with a non-acidic mouthwash
- make sure you see your dentist regularly
- don't drink or eat acidic foods, such as fruit juice, during a binge and after purging
- don't smoke
Vomiting can also lead to risk of dehydration. To avoid this, make sure you drink plenty of fluids to replace what you have vomited.
Antidepressants should not be offered as the only treatment for bulimia. But you may be offered an antidepressant, such as fluoxetine (Prozac), in combination with therapy or self-help treatment, to help you manage other conditions, such as:
Antidepressants are very rarely prescribed for children or young people under 18.
Where treatment will happen
Most people with bulimia will be able to stay at home during their treatment. You will usually have appointments at your clinic and then be able to go home.
However, you may be admitted to hospital if you have serious health complications, including:
- being very underweight
- problems with your heart
- being very ill and your life being at risk
- being under 18 and your doctors believing you don't have enough support at home
- doctors being worried that you might harm yourself or are at risk of suicide
Your doctors will keep a very careful eye on your weight and health if you're being cared for in hospital. They will help you to reach a healthy weight gradually, and either start or continue any therapy you are having.
Once they are happy with your weight, as well as your physical and mental health, you should be able to return home.