Bulimia help
It can be really difficult to admit that you need help but the sooner you get help, the easier it is to recover.
Try talking to someone you know about how you are feeling. You might want to talk to a parent or friend or it could be someone else, another relative or school nurse. Once you have spoken to someone, try and get the courage to go and see your GP.
A doctor will probably ask you these questions:
1) Do you make yourself sick?
2) Do you worry that you’ve lost control over how much you eat?
3) Have you recently lost more than a stone in three months?
4) Do you think you’re fat when other people say you’re thin?
5) Does food dominate your life?
If you answer “yes” to two or more of these questions, you may have a problem with your eating.
Your GP has to respect patient confidentiality and so would not tell your parent or carer unless your health was seriously at risk. However sometimes it is helpful for your family to help with your recovery.
If your symptoms are mild, they may refer you to a self-help book and talk to you about what you can do. Nice is the National Institute of Health and Clinical Excellence and makes recommendations to healthcare professionals. It suggests that patients with bulimia nervosa should be encouraged to follow an evidence-based self-help programme as a first step. If it is more serious, the GP may prescribe medicines that will help or he or she would refer you to a specialist.
Helping yourself
- Stick to three regular meals at specific times and if your weight is very low, have morning and afternoon snacks.
- Keep a diary of what you eat, when you eat it and what your thoughts and feelings have been every day. You can use this to see if there are links between your thoughts and what you eat.
- Be honest with yourself and others about what you are or are not eating.
- Remind yourself that, if you lose more weight, you will feel more anxious and depressed.
- Make sure you know what a reasonable weight is for you and what you need to eat to get there.
- Read stories of other people’s experiences of recovery in self-help books.
- Think about joining a self-help group which your GP may be able to recommend.
- Don’t weigh yourself more than once a week.
- Don’t cut yourself off from family and friends.
Talking to a specialist
If you talk to a specialist/therapist, a psychiatrist or counsellor, they will be trained to talk to you about any problems that you have. They will want to know how long you have had a problem with food, when it developed and why and will talk to you about your thoughts and feelings.
In most cases, you will be seen as an out-patient. This means you see your therapist for an appointment in hospital but go home afterwards, you don’t have to stay in hospital overnight. If your weight is dangerously low and you have bulimia and anorexia and your weight loss poses a threat to your health then you may have to stay in hospital.
They may want to talk to your family too, but only if you are happy with that, as your family can help with your recovery. Nice recommends that families are involved where possible.
Your therapist may refer you to a dietician who will talk about food and the effect of bingeing and purging on your body and how to get back to a healthy pattern of eating. They will also recommend that you have a general physical health check including your teeth as prolonged vomiting can affect your teeth.
Psychological treatment
Cognitive Behavioural Therapy
This is the most common type of psychological treatment for bulimia. Nice states that ‘adolescents with bulimia nervosa may be treated with CBT for bulimia nervosa adapted as needed to suit their age, circumstances and level of development, and including the family as appropriate’.You will talk to a therapist about your thoughts and feelings to work out new ways of thinking about situations, feelings and food. Your therapist may suggest you keep a food diary which will help determine what triggers your binge eating.
Interpersonal therapy
Interpersonal therapy (IPT) involves meeting with a therapist to discuss your condition. However, the focus is more on your personal relationships than your problems with food. You are more likely to be referred for this type of psychological treatment if you have experienced a big change in your life. IPT aims to help you establish supportive relationships and take the focus away from eating.
Antidepressants
Your GP may prescribe you with antidepressants called Selective Serotonin Reuptake Inhibitors (SSRIs) which can prevent the urge to binge eat. The GP would usually prescribe fluoxetine, brand name Prozac. Antidepressants are usually given alongside other therapy. They can take a couple of weeks to kick in so don’t worry if you don’t feel any different overnight. Nice says that no other drug other than antidepressants should be given for the treatment of bulimia.
Hospital treatment
Bulimia is not usually treated in hospital. However, if you have serious health complications and your life is at risk, you may be admitted to hospital. Nice says that the great majority of people with bulimia will be treated as an out-patient (someone who comes into hospital for a meeting or session or treatment and then goes home again, they don’t have to stay over night) but patients who are considered at risk of self-harm or suicide would be treated in hospital in severe cases.
The Nice guidelines on eating disorders are available here
See our next section for further information about getting help.
I was really nervous when I came into the unit and I wouldn’t talk to the staff, and I wouldn’t talk to the other patients, but now I’m really involved with it, I’m having a laugh at my dinner time, I sometimes even look forward to my food, which I really thought would never happen.”