Treatments for Bulimia - Diet and Nutrition

Treatments for Bulimia

Some bulimic patients have been treated successfully with behavioral modification programs. Patients with severe cases, however, sometimes require intensive treatment, either in a hospital or an inpatient unit. Medication, including antidepressants, may also be useful in certain circumstances, although there is to date no antibulimia drug per se, as reported by D. B. Woodside and P. Garfinkel in Nutrition Today (June 1989).

The nontraditional approach to bulimia recognizes that while genetic and physiological factors may contribute to the disorder, any successful elimination of the problem must involve rebuilding the patient's self-esteem. Holistic physicians normally avoid prescribing antidepressant drugs because they have side effects, including dependency, and do not eliminate the underlying psychological causes of bulimia. A controlled pharmacological approach, however, can prove useful, particularly in the early stages. For example, a study conducted at the University of Pittsburgh School of Medicine found that bulimic women eat more when supplies of the brain chemical serotonin are depleted. Small doses of natural or synthetic serotonin might help prevent binge eating, and hopefully further study will lead to a more successful treatment, according to an article by A. James Giannini in the April 1990 American Family Physician .

Psychological approaches may also prove effective. For example, bulimic patients often mistakenly think that vomiting helps them lose weight quickly. In fact, however, vomiting does not immediately cause weight loss because calories are retained in the gastrointestinal tract even after vomiting. Bulimic patients in several studies have been shown to eat slower than control groups, and they also take significantly longer to start eating. If bulimic patients are placed in support groups that stress exercise and intervention begins before the bulimic person initiates binge eating, eventually it may be possible to cure their disorder.

According to Maurice Shils in Modern Nutrition in Health and Disease, underweight patients with anorexia and bulimia usually do not need to consume above-average quantities of food. The initial use of small quantities meets the psychological needs of the patient, who is fearful of gaining weight rapidly. Eating large quantities and high-caloric snacks can actually be counter-therapeutic. Treatment includes the following phases: obtaining a detailed diet history, determining the calorie content of the initial diet, designing an appropriate diet plan, planning gradual progression in the diet, considering weight gain expectations, and designing a diet plan for weight maintenance.

In general, both anorexics and bulimics must avoid fasting, skipping meals, and eating inadequate amounts at meals, since they often contribute to a recurrence of destructive eating habits. Keeping food records is also extremely helpful and should include a notation of the times of the binges, the kinds of foods eaten, and the occurrence of vomiting and laxative and/or diuretic abuse.

Eating wholesome natural foods is the most important factor in maintaining optimum holistic health. Everyone needs to consume the proper amounts of the essential nutrients of water, proteins, carbohydrates, fats, vitamins, and minerals in order for the body to function smoothly and maintain its natural balance. Eating less than the minimum daily recommended amounts of foods can cause severe physiological disorders, while over-consuming unnecessary foods can also cause serious medical complications. By applying the nutritional guidelines outlined in this chapter, and keeping a food diary, most people will be able optimize their diet.