Seeking help for Bulimia Nervosa

Bulimia nervosa is a life-threatening condition and cannot be left untreated (click here for the medical complications of bulimia nervosa). The cause and the severity of an eating disorder can vary from person to person and will manifest or show itself in the symptoms and in behaviour such as excessive eating, binging and purging, excessive exercise, the use of laxatives, etc (click here to go to the causes).  The severity itself is an important clue to the problem (click here for the clinical features and observable behaviours). There are many women who appear to be a normal weight but who can only maintain this by being bulimic (remember that bulimia nervosa is not only about vomiting food.  See identification for other signs such as excessive exercise, the use of laxatives, enemas and diuretics).  Unfortunately, most people try and change the symptom, i.e. the aspect or manifestation that is observable.  Trying to stop bulimia without addressing the underlying causes may result in the problem becoming further entreneched.

 

This eating disorder is the most difficult to recognise because of the secretiveness of the ritual.  If you, or someone you know has bulimia nervosa, please remember that help is available.  As with all eating disorders, bulimia nervosa is a multi-factorial problem that requires an inter-disciplinary approach.  That is, the following team of professionals should be consulted:

1.

The family physician: You family doctor will carry out the necessary tests which will include electrolyte balances, kidney and live function tests, blood counts, etc.  S/he will exclude the possibility of any medical factors that may be causing the problem.  Please ask him/her for the name of a reputable psychologist who works with eating disorders. 

 

2.

A psychologist.  A psychologist can be approached directly if the problem is recognized in its early stages.  S/he will assess the problem and suggest if physical tests are necessary.  Bulimia nervosa cannot be solved in a few sessions and long-term therapy is usually required.  The psychologist will recommend the required length of time. (Click here to find out what you can expect from the psychological evaluation). See causes to understand the kind of psychological factors that are at play with bulimia nervosa. Do not dabble with this problem.  Seek the right help as soon as possible. Psychologists who work with eating disorders work in conjunction with a dietician. 

 

3.

A dietician.  As commented above, eating disorders should never be treated from the dietary aspect alone (see causes).  Dealing with the food problem without dealing with the underlying psychological factors can result in the problem becoming entrenched and difficult to treat.  Dieticians who specialize in eating disorders will work in conjunction with a psychologist. 

 

4.

A psychiatrist, if necessary.  Usually the family physician and the psychologist can assess whether this problem requires the additional input of a psychiatrist.

 

5.

The family dentist will need to assess the damage done to the teeth as a result of purging.  (See medical complications of bulimia nervosa).

 

6.

An exercise specialist.   If you are overweight, you may wish to consider a weight loss programme that offers exercise as a component, or a personal trainer.  Seek help from the right people. SARPT - S.A. Registered Physical Trainers.

An attempt to change only the symptom (the weight problem, the bulimia) is one of the reasons why people with an eating disorder constantly reappear at different help stations.  Please bear in mind that there are psychological and historical causes to bulimia nervosa.  It is never just about too little or too much food!

 

TREATMENT FOR BULIMIA NERVOSA

1.

There is a better prognosis than with anorexia nervosa.

2.

Individual psychotherapy, group therapy, family therapy and pharmacotherapy may be necessary.

3.

Bulimics are not necessarily hospitalized unless suicidal or if electrolyte and metabolic imbalances occur. 

4.

Medication, if necessary.

 

The following are tell-tale signs to watch for if you have, or know someone who has this disorder:

1.

Extreme weight loss.

2.

Extreme weight variations.

3.

Excessive exercise/excessive compliance.

4.

Physical aspects:

1.

Is there a change in appearance for the worse?

2.

Is there a decrease in energy?

3.

Is there an increase in the number of injuries?

4.

Is there an increase in minor illnesses such as colds, flus, sore throats, etc?

5.

Is there a shift in moods or the presence of depression?