Bulimia is a serious eating disorder affecting 0.3% of the population. The prevalence of bulimia is ten times higher for women than men. Among men, it is more common for homosexual or bisexual men to develop bulimia compared to heterosexual men.
However, regardless of gender or sexual orientation, it is true that bulimia has life-threatening effects on people who suffer from it. Around 3.9% of people with bulimia die every year from complications caused by excessive binging and purging, or from suicide.
Only a minority of those with bulimia get mental health care, but this doesn’t have to be the case. There are plenty of treatment options that can help you break the pattern of binge-purging behavior. Face-to-face and online therapy for bulimia are readily available when you’re ready to seek help.
What Is Bulimia?
Bulimia nervosa, or simply bulimia, is an eating disorder characterized by binging followed by purging. People with bulimia will often eat large amounts of food, a behavior called binging. This often involves more snacks and desserts and fewer fruits and vegetables.
People with bulimia can eat up to 20,000 calories at a time, which is a lot to eat in a day, much less one sitting.
After a binge, people with bulimia often try to get rid of the excess calories to avoid weight gain in a behavior called purging. There are many ways a person with bulimia can do this, either by self-induced vomiting, excessive exercising, or using laxatives and diuretics to medically force out what they binged.
Bulimia can lead to many health problems, from gastrointestinal symptoms such as bloating, flatulence, constipation, and nausea, to dehydration and heart problems. Bulimia can also lead to oral complications, a burst esophagus, and swollen salivary glands.
The cause of bulimia is not yet known, but research has identified risk factors that may make a person likely to develop bulimia. These include experience with childhood sexual abuse, body dissatisfaction, substance abuse, early puberty, calorie counting, having too little to eat during childhood, and psychiatric symptoms.
The Symptoms of Bulimia
It may be difficult for people with bulimia to recognize or admit that they have a problem. They may even try to hide their symptoms from people in fear of being rejected or judged. This is why it may be difficult to know if a person has bulimia.
Here are the signs a person may have bulimia nervosa.
- Eating an amount of food that is definitely larger than what most people would eat in a two-hour period, followed by a sense of guilt that will make one want to purge
- Purging behaviors such as self-induced vomiting, excessive exercise, and use of laxatives and diuretics usually done in secret
- Using dietary supplements for weight loss excessively
- Feeling that one cannot stop eating or control how much and what they are eating
- Excessive fasting
- Peculiar eating habits
- Calorie counting
- Irregular menstruation cycle or absence of menstruation entirely
- Preoccupation with body weight and shape
- Constant or recurrent inflamed or sore throat
- Low self-esteem and fear of getting fat
- Dental problems as a result of vomiting
- Swelling cheeks, hands, and feet
- Having sores, scabs, or calluses on knuckles or hands
- Impulsiveness and risky behaviors, such as abuse of alcohol or drugs
Certain symptoms of bulimia may coincide with other health problems, so if you’re suspecting someone or yourself of having bulimia, be sure to get a proper diagnosis from a medical provider.
Types of Therapy for Bulimia
Treatment for bulimia focuses not only on food and nutrition education but also on mental health treatment. Therapy for bulimia will help develop a healthy self-image and a healthy relationship with food.
Here are several therapeutic approaches applied to people with bulimia.
Cognitive behavioral therapy (CBT)
CBT therapy for bulimia is a type of therapy that helps people identify and change negative thought patterns, emotional responses, and associated behaviors. People with bulimia often have distorted views of themselves and their body. CBT can help them learn to focus on present thoughts and beliefs and develop a healthier thinking pattern.
There are several forms of CBT, and one is specifically aligned to treat eating disorders. CBT-E, or CBT-enhanced, is an enhanced form of cognitive behavioral therapy for bulimia that addresses psychopathological processes “external” to the eating disorder. This extends the treatment to digging deeper into clinical perfectionism, food intolerance, low self-esteem, and interpersonal difficulties that often contribute to the maintenance of bulimia.
CBT-E generally has four stages, the first being aimed at engaging the client in treatment and change by identifying the processes maintaining the eating disorder and monitoring the patient’s eating and other relevant thoughts and behaviors. Therapists will then educate the client regarding body weight regulation and fluctuations, as well as the risks and ineffectiveness of purging behavior on weight control.
Slowly, the therapist and the client will monitor the client’s progress and modify the treatment plan as needed, identify barriers to change, if any, and then treatment will focus on identifying the mechanisms maintaining the disorder. At stage four, the therapy will progress into ensuring that any progress made will be maintained.
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Interpersonal therapy (IPT)
Interpersonal psychotherapy for bulimia (IPT) operates under the premise that symptoms of bulimia are related to interpersonal issues. Thus, addressing personal problems may alleviate symptoms of bulimia.
IPT is a short-term, evidence-based treatment and has been identified as an effective treatment for bulimia. While CBT focuses on changing negative thought patterns, IPT focuses on helping people with bulimia understand how their interpersonal relationships contribute and associate with their symptoms.
Both IPT and CBT have been shown to significantly decrease general psychiatric features of bulimia, as well as improve a patient’s self-esteem and social functioning.
Much like CBT, IPT is divided into treatment phases which begin with helping the client become more aware of how interpersonal factors are associated with symptoms of bulimia. Treatment then moves forward to helping the client address and resolve their interpersonal conflicts and problems, whether it be from their family, friends, or significant others.
The third phase of interpersonal therapy for bulimia focuses on how to stop the binge-and-purge cycle of behavior and monitors the progress made by the client. In the final phase, the therapist will help the client learn ways to deal with possible interpersonal difficulties in the future.
Psychodynamic therapy for bulimia focuses on interpretations of the mental and emotional processes of the client and how they manifest in a client’s behaviors. In simpler terms, it focuses on the underlying reasons for the behavior instead of the behavior itself.
The main goal of psychodynamic therapy for bulimia is to help the client become self-aware and understand how their past influences their actions in the present.
There are many different kinds of psychodynamic therapy that are effective for people with bulimia, including group therapy. The form used will largely depend on the individual needs of the client. Regardless of the form, research suggests that psychodynamic therapy is largely effective for clients with psychological disorders.
Can Online Therapy for Bulimia Help?
Traditionally, therapy is conducted in a therapist’s office. However, recent developments in technology have opened up new ways to conduct and receive therapy.
Online therapy for bulimia is not just a good alternative to face-to-face therapy. Research suggests it’s as effective as in-person therapy.
Online counseling presents several benefits to people with bulimia. Due to the therapy being done completely online, you have the freedom to choose where best to conduct it, whether it be in your own room at home, somewhere more scenic, or even at work should something trigger your symptoms while in a stressful situation.
Online therapy helps bridge the gap between therapist and client by making sessions and messages easily set up and accessible. There’s also more flexibility in online therapy for setting schedules, and because there are more options for therapists, one can easily change into a new one if the therapist first assigned to them isn’t compatible with their needs.
So Should I Try Online Therapy for Bulimia?
In the current social and technological climate, online therapy for bulimia is one of the best options to treat this serious eating disorder. Combined with nutritional counseling and medications where applicable, it is possible for people with bulimia to develop a healthier sense of self and relationship with food using online therapy.
Here at DoMental, we have a network of therapists that covers a wide range of specialties to best match your personal needs. Our platform guarantees privacy and security during your online counseling, as well as anonymity, so you can work at your own pace and share only what you’re comfortable with sharing.
Wherever you are, you can get access to a licensed therapist who will listen to you and help you feel better, step by step.