Bulimia nervosa and binge-eating disorders treatments.

Bulimia or binge-eating disorders are a serious condition that can affect someone for a very long time. It can affect anyone from any age or any gender and from any background. People who suffer from this disorder eat large volumes of food. Bulimia sufferers then try to compensate for binging by taking laxatives, diuretics or vomiting.

Initially, guided self help may be offered before therapy. This works by monitoring eating habits, making realistic meal plans and learning about the triggers causing these disorders. Self-help May also consist of support groups in the local area or online where sufferers can open up and learn about their feelings with food and finding ways to cope with it. If self-help doesn’t work it doesn’t work well enough, therapy will be offered but this is usually after at least four weeks of self-help.

Therapy can be recommended to tackle underlying thoughts and feelings that may be causing eating disorders. Therapy can highlight healthier ways of coping. There are three types of therapy a professional might suggest. [1]

• Cognitive-behavioral therapy adapted to suit the needs of people with bulimia

• Interpersonal psychotherapy

• Evidence-based self-help. Ideally with support and encouragement from your healthcare team.

CBT is the most likely recommended therapy to be offered as part of treatment.

Cognitive Behaviour Therapy

Most clinical trials have shown Enhanced Cognitive Behaviour therapy to be most effective in treating anorexia. Bulimia and binge-eating disorders. [2] Enhanced CBT has been specifically designed to manage eating disorders. It is a structured time-limited treatment with three phases. [3]

Three phases

1. CBT starts with developing healthy coping mechanisms. It is an important aspect of therapy because the therapy will challenge beliefs. One of the exercises CBT teaches is breathing exercises to naturally calm down.

2. the second phase of CBT promotes mindfulness – becoming aware of inner thoughts and feelings. Mindfulness helps to curb negative thought patterns that can reinforce worries or strengthen unhealthy thought patterns and emotions. Addressing the current state of mind can reduce the negativity and promote positive behaviors

3. CBT focuses on identifying personal triggers and then exposing the patient to those triggers. These triggers can be sights, or noises, locations, experiences or smells. CBT focuses on addressing these triggers and create a guide to handling them. It will help address the thoughts and feelings arising from the triggers. CBT encourages the use of journals and recording emotions or thoughts when exposed to triggers or highly emotional events then encourages relaxation techniques such as breathing exercises to help negotiate the situation and react in a healthy and positive response.

Establish a regular pattern of stable eating

Regardless of the condition, CBT-E establishes a regular pattern of eating and addresses different factors causing the condition such as focusing on shape, weight or mood-related eating,

Least restrictive

Restrictive settings, like residential treatment centers or hospitals, are for people with extensive symptoms or medical complications. For people who are medically stable and able to participate in outpatient treatment, Day treatment programs or intensive outpatient programs would be better suited to their needs and it would be in their best interests to pursue this less restrictive option.

Dialectical behavioral therapy

According to a recent paper, evidence supports using dialectical behavior therapy with adult bulimia and other binge eating disorders. There is evidence to suggest DBT can be effective with eating disorder patients who also have a borderline personality disorder. [2]

References:

1. Treatment for Bulimia. (2020). Retrieved 21 January 2020, from https://www.beateatingdisorders.org.uk/types/bulimia/treatment

2. Gerson, M. (2020). Best Practices: The Evidence-Base for Eating Disorder Treatment - Columbus Park. Retrieved 21 January 2020, from https://columbuspark.com/2016/09/19/best-practices-the-evidence-base-for-eating-disorder-treatment/

3. 3 Phases of Cognitive Behavioral Therapy (CBT) - Thrivetalk. (2020). Retrieved 21 January 2020, from https://www.thrivetalk.com/3-phases-cognitive-behavioral-therapy-cbt/