How is bulimia treated?

Patients with bulimia present a variety of medical and psychological  complications which are usually considered to be reversible through a  multidisciplinary treatment approach. Treatment can be managed by either a  physician, psychiatrist, or in  some cases, a clinical psychologist. The extent of the medical complications  generally dictates the primary treatment manager. A  psychiatrist, with both medical and psychological training, is perhaps the  optimum treatment manager.

A number of antidepressant  medications have been shown to be beneficial in the treatment of bulimia.  Several studies have demonstrated that fluoxetine (Prozac), a member of the  selective serotonin reuptake inhibitor (SSRI) class of antidepressants, has been effective in the  treatment of bulimia. And the U.S. Food and Drug Administration has approved  fluoxetine for the treatment of bulimia.

Other types of antidepressants, including the monoamine  oxidase inhibitors (MAOIs), tricyclic antidepressants, and buspirone (Buspar)  have all been shown to decrease bingeing and vomiting in people suffering from  bulimia. However, the SSRIs remain the first choice for treatment due to their  relative safety and low incidence of side effects.

Other  drugs are currently under investigation as possible treatments for bulimia.  Examples are the antiepileptic drug topiramate and the serotonin antagonistondansetron.

Some patients may require hospitalization due to the  extent of the medical or psychological complications. Others may seek outpatient  programs. Still others may require only weekly counseling and monitoring by a  practitioner. Stabilization of the patient’s physical condition will be the  immediate goal if the individual is in a life-threatening state. The primary  goals of treatment should address both physical and psychological needs of the  patient in order to restore physical health and normal eating patterns. The  patient needs to identify internal feelings and distorted beliefs that led to  the disorder initially. An appropriate treatment approach addresses underlying  issues of control, self-perception, and family dynamics. Nutritional education  and behavior management provides the patient with healthy alternatives to weight  management. Group counseling or support groups can assist the patient in the  recovery process as well.

The ultimate goal should be for the patient to accept  herself/himself and lead a physically and emotionally healthy life. Restoration of  physical and mental health will probably take time, and results will be gradual.  Patience is a vital part of the recovery process. A positive attitude coupled  with much effort on the part of the affected individual is another integral  component to a successful recovery.

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