• Programs for Eating Disorders

    Bulimia Nervosa

    We Can Help You Recover From Bulimia!

     

    Please know that we are here to help you. We offer treatment for Bulimia as well as other eating disorders.

    In order to receive help for overcoming bulimia, the first step is to contact our Intake Coordinator at 314-289-9411. Our Intake Coordinator will match you to one of our clinicians who will evaluate your concerns and make treatment recommendations to you.  Your insurance coverage will also be reviewed by the intake coordinator.

    The first step is an important one and only you can place the call.

    Bulimia Nervosa

    “Sometimes I can’t help it, I just have to eat, and then I can’t stop.

    After that I have no choice but to make myself throw-up or get rid of what I ate.”

    “I am ashamed that I purge, but if I didn’t, I would be really obese. And that is worse than purging.”

    The essential feature of Bulimia Nervosa is binge eating. To binge often means eating more than most people would in that situation, but what defines a binge is that the behavior feels out of control.  Often a person eats to the point of physical discomfort and may not even taste the food.  The binge episode is followed by feelings of remorse and disgust.  Due to shame involved, bingeing is often secretive.  Bingeing may be precipitated by emotions such as loneliness, boredom, sadness or anger or occurs to reduce anxiety.  Another critical feature in Bulimia Nervosa is compensating for the binge eating in some fashion, such as self-induced vomiting, misuse of laxatives, diet pills and diuretics, fasting, or excessive exercise.  Purging behavior may occur occasionally or multiple times daily. iStock_13345757XSmall_ED_Bulimia

    Like Anorexia Nervosa, individuals with Bulimia Nervosa place an exaggerated emphasis upon body size and appearance as the basis for judging one’s worth and that of others.  It is estimated that up to half of individuals diagnosed with Anorexia Nervosa will develop symptoms of Bulimia Nervosa. Individuals with Bulimia Nervosa are often at or near their ideal body weight. Individuals with Bulimia Nervosa are also likely to have mood disorders, anxiety disorders, trauma histories and impulse control disorders.

    As seen in Anorexia Nervosa, when excessive exercise is used as a compensatory mechanism for eating, the exercise may become so extreme as to not only burn calories consumed, but burn fat reserves to the extent that serious damage may occur to the body.

     Medical Complications

    One very serious consequence of repeated vomiting or laxative use is that the body is depleted of important chemicals like sodium and potassium, called electrolytes. Electrolyte depletion can disrupt heart functioning and cause deterioration of the kidneys, both of which are potentially fatal.

    Other medical complications include erosion of the teeth, constipation, swollen parotid glands, chronic gastric reflux, dizziness, irritation of the esophagus, gastroparesis (delayed emptying), constipation, peptic ulcers, and disruption of the menstrual cycle. Most of these problems readily improve if the purging stops and a healthy meal plan followed.Morning in the field

    Individuals with Bulimia Nervosa are also found to represent a high suicide risk and care should be given to monitoring and treating symptoms of depression that may initially worsen as binge/purge cycles are interrupted.

    Bulimia Nervosa Treatment

    The treatment of Bulimia Nervosa, which has the strongest scientific support of its long-term effectiveness, is cognitive-behavioral therapy (CBT). There is recent research support for Enhanced CBT for Eating Disorders (CBT-E), which is a form of CBT that focuses on the processes maintaining eating disorders, with specific interventions focusing on low self-esteem, clinical perfectionism, and interpersonal relationships.  In our bulimia treatments in St. Louis, MO, the patient begins by monitoring nutritional intake and thoughts and feelings about eating. A nutritionally balanced meal plan is then implemented. For overcoming bulimia, the patient learns effective strategies to cope with anxiety about eating and the urge to binge and purge. Finally, inaccurate and harmful beliefs about eating, weight, appearance and personal qualities are identified and modified to encourage healthy self-appraisal.

    Dialectical behavior therapy (DBT) has also found to be an effective bulimia treatment approach, and serves to augment CBT treatment for Bulimia Nervosa.  DBT contributes mindfulness practices and specific skills to assist with emotional self-awareness, distress tolerance and self-regulation.  Interpersonal Psychotherapy (IPT) has also received research support as an effective treatment for Bulimia Nervosa and binge eating.  IPT focuses on addressing interpersonal problems and deficits associated with low self-esteem and negative emotion.   In Bulimia Nervosa, food is often provides a way to cope with negative feelings and aversive self awareness. The goal of therapy is to develop healthy and satisfying relationships.

    Antidepressant medication can be helpful in reducing the frequency of binge eating and purging in the short-term. Unfortunately, the eating disorder symptoms are likely to return with extended use or if the medication is discontinued. Unless dysfunctional beliefs are changed and healthier methods of coping are developed, the individual is likely to return to bulimic behavior patterns. In severe or treatment-resistant cases, a combination of CBT and antidepressant medication is often the best course. The use of medication to treat Bulimia Nervosa without psychotherapy is not recommended.

    If you suspect that you or someone you know is struggling with Bulimia Nervosa, please contact our bulimia treatment center in St. Louis, MO at 314-289-9411.