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Explaining the Basics of Recovering from Bulimia Nervosa

Treatment for eating disorders is a complex, challenging process involving cognitive behavioral therapy, family therapy, individual counseling, and group therapy. In addition, bulimia nervosa recovery relies on ongoing support from the client’s family, close friends, and counselors providing outpatient services at eating disorder treatment centers. Before starting the recovery process, eating disorder therapists develop a personal, comprehensive treatment plan based on the unique life experiences of clients that are designed to address all mental and physical health needs.

Recognizing Signs of Bulimia Nervosa

Bulimia nervosais the product of a person’s inability to self-evaluate correctly. Self-evaluation among people with bulimia nervosa or anorexia nervosa focuses solely on the superficial appearance of the body–size, shape, and weight. The physical and psychological experience of depriving the self of food through extreme dieting ultimately contributes to binge-eating episodes. After eating an enormous amount of food, the individual becomes panic-stricken with fear of gaining weight combined with deep shame and guilt over losing control during a binge-eating episode.

Adolescents and young adults with bulimia nervosacan become fixated on what they think is an “ideal” body shape and weight. Perfectionism of this magnitude leads to a negative and distorted self-evaluation process that responds to a failure to meet unattainable high standards. Mood intolerance (an inability to cope with adverse states of mind and emotion) promote participation in bulimia nervosa behaviors as well as sustained depression and generalized anxiety.

Bulimia nervosa side effects involve health problems that may require extensive medical treatment or hospitalization. They include:

  • Tooth decay due to repeated vomiting after a binge-eating episode. Over time, stomach acid erodes tooth enamel and may cause tooth loss and gum disease
  • Visible swelling of salivary glands
  • Chronic sore throat
  • Hoarse voice (stomach acid damages the lining of the esophagus. Accumulation of scar tissue may also make it difficult to swallow)
  • Dehydration
  • Anemia
  • Electrolyte imbalance (lack of potassium, chloride, and sodium in the body could cause heart arrhythmias and/or heart failure)

Other bulimia nervosa side effects involve worsening depression, anxiety, panic, and obsessive-compulsive habits that propagate most eating disorders. Consequently, a bulimia nervosa recovery demands intensive, preferably residential-type treatment with experienced eating disorder therapists who fully understand the challenging issues clients must cope with to achieve recovery.

How Do People Recover from Bulimia Nervosa?

Gaining control of signs of bulimia nervosa begins with clients developing a feeling of genuine optimism about their ability to overcome their eating disorder. Therapists provide the counseling, insight, and support necessary for clients to understand that bulimia nervosa recovery is attainable in all situations.

Recovering from bulimia nervosa or any eating disorder is an ongoing, subjective process uniquely perceived by the client. Eating disorder therapists show clients how to identify with being a “healthy” individual who does not depend on an eating disorder to define their core identity. During recovery, bulimia nervosa clients also learn to manage unpleasant or intrusive emotions and thoughts without resorting to binge eating and purging behaviors. Equipped with healthy coping strategies following the completion of their treatment program, individuals with bulimia nervosa are better able to solve problems critically and rationally while keeping control of negative emotions.

Principles of a successful bulimia nervosa recovery include:

  • Valuing the body as functional, healthy, and strong rather than how it “looks”
  • Restoring a compassionate relationship with the body
  • Learning to focus thoughts on more important, meaningful things instead of food
  • Treating the self with more kindness and flexibility
  • Setting boundaries and limits with other people
  • Discovering a purpose in one’s life
  • Constantly improving emotional stability
  • Renewing relationships with family members
  • Creating a rewarding and beneficial social life

It is also vital for bulimia nervosa clients to follow their physician’s orders and take medication as prescribed if they suffer from side effects of bulimia nervosa impacting their physical health. A healthy body is essential for treating psychological disorders underlying the development of an eating disorder.This being said, there are no medications specifically designed or prescribed for bulimia nervosa or other eating disorders. Although psychiatric medication may be used for co-occurring disorders such as depression or OCD, recovery must come from a place of therapy and mindfulness.

Methods of Therapy Used in Bulimia Nervosa Recovery

Effective eating disorder treatment plans are always individualized, i.e. designed specifically for the individual being treated’s particular diagnosis and background. Depending on their treatment plan, therapists may choose one or several different methods of treatment. Within that set o options, some methodologies are used in many situations. Aside from medical and nutritional programming, some of these therapeutic methods might include:

  • Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) has been successful in treating several different conditions and is often used for eating disorder recovery. In simplest terms, CBT can be understood as a type of talk therapy. This type of therapy is often used because it can help people quickly identify and learn to cope with challenges in their lives. CBT is sometimes combined with other types of therapies and medications. CBT is based at least in part on the concept that problems or conditions are based, at least in part, on unhelpful or negative thinking patterns. Identifying and sharing thoughts about an individual’s problems is a major part of CBT.

  • Cognitive Processing Therapy

Cognitive Processing Therapy (CPT) is a type of therapy that focuses on traumatic events in a person’s life and how that individual copes after experiencing such an event. CPT is often used in the treatment of Post-Traumatic Stress Disorder (PTSD). The National Institutes of Health states that PTSD and eating disorders share similar features that include dissociation, impulsive behavior, and cognitive disturbances. CPT progresses through several steps, helping the client understand how trauma reactions are influencing their thoughts and emotions, learning to experience them without acting on them, and gradually moving past their “stuck points” to learn to cope effectively with them.

  • Dialectical Behavioral Therapy

This type of therapy is a modified form of CBT that emphasizes both psychological and social factors. Dialectical Behavioral Therapy (DBT) builds on the principles practiced in CBT. DBT focuses on how some people’s emotions will be aroused much quicker than usual and that their emotional reactions will be much stronger. It is often used to treat people with borderline personality as well as substance use disorder. DBT involves synthesizing opposing points of view and finding a new balance between them. This is achieved via lessons increasing mindfulness about one’s emotions and also distress tolerance lessons that help them manage powerful emotions.

  • Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) stems from CPT and other traditional types of therapy. One of the key components of this type of therapy is for an individual to stop denying and avoiding their inner emotions. People learn to accept that their feelings are, in some circumstances, appropriate responses. The goal is for individuals to accept the difficulties and issues in their lives and then commit to making changes in their current behavior.

Seeking Bulimia Nervosa Treatment Is Easier Than You Might Think

Securing treatment for an eating disorder such as bulimia nervosa can seem like a daunting challenge. As a psychiatric disorder, recovery can be a long and complex process after. The good news is that recovery programs have become more accessible than ever in recent years. It all starts with reaching out. You can make a phone call or send an email to a psychiatrist or directly to an eating disorder treatment center. They will be able to help you assess your treatment needs, and find a recovery strategy that will lead to the best outcomes. It might seem hard to believe at first but the journey to bulimia nervosa recovery begins with a single step.

Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.
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