Treatment of bulimia nervosa

Early treatment is vital. As bulimia becomes more entrenched, its damage becomes less reversible.

Extreme purging rapidly upsets the body's balance of sodium, potassium, and other chemicals. This can cause fatigue, seizures, irregular heartbeat, and thinner bones. Repeated vomiting can damage the stomach and esophagus (the tube that carries food to the stomach), make the gums recede, and erode tooth enamel. (Some patients need all their teeth pulled prematurely). Other effects include various skin rashes, broken blood vessels in the face, and irregular menstrual cycles.

Usually, the family is asked to help in the treatment, which may include psychotherapy, nutrition counseling, behavior modification, and self-help groups. Therapy often lasts a year or more--on an outpatient basis unless life-threatening physical symptoms or severe psychological problems require hospitalization. If there is deterioration or no response to therapy, the patient (or parent or other advocate) may want to talk to the health professional about the plan of treatment.

There are no drugs approved specifically for bulimia, but several, including some antidepressants, are being investigated for this use.

If you think a friend or family member has bulimia, point out in a caring, nonjudgmental way the behavior you have observed and encourage the person to get medical help. If you think you have bulimia, remember that you are not alone and that this is a health problem that requires professional help. As a first step, talk to your parents, family doctor, religious counselor, or school counselor or nurse.