Content

• To step
• Part 1 of 3: Helping yourself overcome bulimia
• Part 2 of 3: Getting help from experts and those around you
• Part 3 of 3: Enlisting the help of family and friends
• Tips
• Warnings

Do you think you may have the eating disorder bulimia nervosa? Do these food problems have a negative effect on your life? An estimated 4% of women in the United States will experience bulimia during their lifetime, and only 6% of them are treated for it. If you think you have bulimia or are looking for treatment, there are a number of options you can explore.

To step

Part 1 of 3: Helping yourself overcome bulimia

1. Find out if you have bulimia. Self-diagnosis of mental illness is not advisable.If you think you need help, see your doctor, especially if you meet the following criteria:
   • Binge eating or consuming large amounts of food in succession.
   • A lack of control over these binges.
   • Using purging and other non-gaining methods such as vomiting, using laxatives / diuretics (to compensate for overeating), fasting, or excessive exercise. People with bulimia do this at least once a week for three months.
   • Problems with your own body image, where your self-esteem is disproportionately determined by how you view yourself (weight, shape, etc.) compared to other factors.
2. Recognize your triggers. If you want to become more aware of this condition, try to find out what your emotional triggers are. These triggers are events and situations that turn your emotional knobs and lead to binge eating and purging. Once you know what they are, you may be able to avoid them or at least try to approach them differently. A few common triggers are:
   • Negative perceptions about your own body. When you look in the mirror, do you have negative thoughts and feelings about your appearance?
   • Social stress. Does arguing with a parent, sibling, friend, or romantic partner make you want to gobble?
   • More general negative moods. Fear, sadness and frustration, among other things, can be the reason for binging and purging.
3. Research intuitive eating. Traditional diet programs are usually ineffective for eating disorders and can actually make symptoms worse. However, intuitive eating can help you change your relationship with food. Intuitive eating is a method developed by dietitian Evelyn Tribole and nutrition therapist Elyse Resch to learn to listen to and appreciate your body. It can help with:
   • Developing interoceptive awareness. Interoception is your ability to be aware of what is going on in your body; it is a must for creating a healthier knowledge of what your body wants and needs. Deficiencies in interoception have been shown to correlate with eating disorders.
   • Gaining self-control. Intuitive eating is associated with reduced disinhibition, loss of control and binge eating.
   • A better overall feeling. Intuitive eating is also associated with general improvements in well-being: less preoccupation with body issues, more self-esteem, etc.
4. Keep a diary. Keeping a bulimia diary will help you stay aware of when you eat what triggers your eating disorder, and it can serve as an expressive outlet for your feelings.
5. Buy just enough food. Do not stock up on too many groceries, so that you have less of a chance to gobble. Plan ahead and bring as little money as possible. If someone else is running your errands, such as a parent, ask them to consider your dietary needs.
6. Plan your meals. Focus on three or four meals and two snacks; schedule these at fixed times of the day so that you know when you are going to eat and can limit yourself to those predetermined times. Make this a routine to avoid the impulsive behavior.

Part 2 of 3: Getting help from experts and those around you

1. Get therapy. Therapeutic interventions such as cognitive behavioral therapy and interpersonal therapy have been shown to aid in recovery, with long-lasting effect. Use psychologytoday.com to find a therapist in your area who specializes in these methods. You can also look for a therapist who specializes in eating disorders.
   • Cognitive behavioral therapy focuses on restructuring your thoughts and behavior so that self-destructive tendencies rooted in these aspects are replaced with healthier ways of thinking and acting. If you are binge eating and purging because of deeply held beliefs about yourself, as many people do, then CBT can help change the basis of these thoughts and expectations.
   • Interpersonal therapy focuses on relationships and personality structure, rather than more clearly defined thought patterns and behaviors, so it can be more effective if you want less set instructions or thought restructuring and focus more on your relationships with family, friends, and even yourself.
   • Therapeutic collaboration is one of the most important factors in the effectiveness of therapy, so make sure you find a therapist you can work with. This may mean "shopping" until you find someone you trust, but it can mean the difference between recovery or relapse, so don't settle for anything!
2. Investigate which medication is possible. In addition to therapy, certain psychiatric medications can help treat bulimia. The first-line medications recommended for eating disorders are antidepressants, especially SSRIs such as fluoxetine (Prozac).
   • Ask your doctor or psychiatrist about possible anti-depressants for bulimia.
   • Medication is most effective in some mental illnesses when combined with therapy, rather than on their own.
3. Join a support group. While there is not much research data on the effectiveness of joining groups that support eating disorders, some people indicate that groups such as Overeaters can be anonymous helpful as an additional treatment option.
   • To find a support group in your area, use this website: click here.
4. Consider admission to a day treatment. If you are one of the serious cases of bulimia, you can consider admission to a psychiatric clinic. This provides access to better medical and psychiatric care, compared to the self-directed methods, outpatient therapy or support groups. You may need a recording if:
   • Your health is deteriorating or your life is threatened as a result of bulimia.
   • You have been treated before and are experiencing a relapse.
   • You experience additional health complications, such as diabetes.
5. Search for recovery websites. Many people use internet forums to help with eating disorder recovery. These websites can be an important source of interpersonal support, enabling people suffering from these conditions to discuss the specific difficulties of living with eating disorders with those who are going through similar struggles. Here are a few websites you can check out:
   • Bulimiahelp.org Forum.
   • Psychcentral.com Forum on Eating Disorders.
   • National Association of Anorexia Nervosa and Associated Disorders Forum.

Part 3 of 3: Enlisting the help of family and friends

1. Educate your support system. Research suggests that family support can play an important role in the recovery process. To give yourself the best possible chance for recovery, it is wise to inform your family and friends about the condition. This will cultivate a social environment in which healing can begin. Use websites such as Brown University's health education center and Caltech's guide to helping friends with eating disorders.
2. Invite friends and family to attend educational events. Ask your local college, hospital, or mental health clinic for more information about educational events focused on bulimia. These events will help those who are close to you discover how they can be of service during your recovery process. They learn healthy communication techniques as well as general information about bulimia nervosa.
3. Be clear about your needs. Family and friends may be happy to support you, but may not be clear on how to do it. Let them help by being clear about what you need. If you have certain nutritional issues, or if you feel like your eating habits are being criticized too much, talk about these issues!
   • There is research linking bulimia to parenting styles that are dismissive, unbalanced, or overly involved. If your parents exhibit these styles, talk to them about what you feel you are not getting, or are getting, in terms of attention. If your dad keeps teasing you all the time while you eat, tell him that you appreciate all the concerns, but the over-involvement makes you feel more negative about yourself and your behavior.
   • Research also suggests that in many families where eating disorders arise, communication is not appreciated or ignored. If you feel like you are not being heard, bring it up in an assertive but unbiased way. Tell your mom or dad you want to tell them something important but are afraid it won't be heard. This will convey your concern and help them understand what you mean.
4. Eat with the whole family. Research shows that people who eat at least three meals a week with the family are significantly less likely to develop an eating disorder.
5. Consultation about family therapy. Family therapy is a proven effective treatment involving family members in the therapeutic process. Research shows it is effective to use in adolescents, possibly more than individual therapy.

Tips

• Bulimia has a high rate of relapse, so don't feel guilty or give up if you don't manage to recover right away.

Warnings

• Bulimia can lead to a variety of dangerous health problems, including malnutrition, hair loss, tooth erosion, esophageal rupture and even death. If you have a serious case of this condition, see your doctor immediately.