4 ways to help treat bulimia

Like all eating disorders, bulimia can be difficult to treat and usually requires a team approach involving nutrition education, medications and psychotherapy. If the patient appears to be suicidal or the intractable binge-purge behaviour does not respond to outpatient therapy, hospitalization may be necessary. Don't expect instant success, however; treatment often takes three years or more, and even then, relapses are common.

Treat nutritional deficiencies early. This is especially important if the body's potassium reserves have been depleted by vomiting or laxative abuse.

• Eating high-potassium foods, such as dried fruits, bananas and fresh fruits and vegetables, usually restores the mineral; if not, a supplement may be needed.

Keep a diary. Nutrition education typically begins with asking the person with bulimia to keep a diary to help pinpoint circumstances that contribute to binging. A nutrition counsellor may also give the patient an eating plan that minimizes the number of decisions she must make about what and when to eat.

• This diet should emphasize foods high in protein and starches while excluding favourite binge foods until the bulimia is under control; they can then be reintroduced in small quantities.
• At this stage of treatment, the person with bulimia learns how to give herself permission to eat desirable foods in reasonable quantities, in order to reduce the feelings of deprivation and intense hunger that often lead to loss of control in eating.
• Bulimics who abuse laxatives may need a high-fibre diet to overcome constipation. Wholegrain cereals and breads, fresh fruits, vegetables and adequate fluids should help restore normal bowel function. It also helps to lower cholesterol levels, strengthen blood vessels and lower blood pressure.

Because chronic clinical depression often accompanies bulimia, treatment usually includes giving selective antidepressant drugs that restore normal levels of serotonin, a brain chemical instrumental in mood control and appetite.

• The most commonly prescribed drugs for bulimia are the serotonin-reuptake inhibitors like fluoxetine, which also suppresses appetite, and sertraline.
• As patients recover from their depression, they are better able to control their compulsive eating.

Psychotherapy may be an option. It can take several forms, including family and group therapy, as well as cognitive behavioural therapy to help the patient shift the central focus of her life away from food.

• Bulimics also learn to recognize the warning signs of a binge and how to deal with stress or situations that make them vulnerable to binges.
• Participation in self-help groups can also be useful.
• In addition, alternative therapies, such as meditation, guided imagery and progressive relaxation routines, can help patients become less obsessive about weight and their eating habits.

Keep these tips in mind and help treat bulimia the right way. Remember to contact your doctor for more useful information.