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Suffering from bulimia. How to overcome this problem?

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Practicing since : 2003
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how can I manage my bulimia my bulimia is out of control how do I manage it I try to keep down small meals but when I get really stressed I have no control over it I was doing good for about a month
Posted Thu, 28 Feb 2013 in Eating Disorders
Answered by Dr. Jonas Sundarakumar 1 hour later
Hello and welcome to Healthcare Magic. Thanks for your query.

I'm sorry to hear that your bulimia has recurred after doing good for while. Now, stress is indeed, a major trigger for bulimic episodes. So, avoiding stress as much as possible and learning to handle stress and cope up whenever it is unavoidable will help control the bulimia.

Though dietary adjustments may be helpful in controlling bulimia, they will help only superficially and temporarily. This is because the actual underlying roots of bulimia are are low self esteem and poor body image. So, these emotional issues have to be addressed in order to have long-lasting results.

The treatment of choice for bulimia is Cognitive-Behavioral Therapy (CBT). Cognitive-behavioral therapy targets the unhealthy eating behaviors of bulimia as well as the underlying negative thoughts that fuel them. CBT will usually be in three phases:
1) The first phase of CBT for binge eating will focus on helping the person with bulimia break their pattern of unhealthy eating — the binging and purging cycle.
2) The second phase of CBT will help the person with bulimia better understand their dysfunctional and broken beliefs about their self-esteem, self-image, weight and body shape.
3) The final phase of bulimia CBT will target the emotional issues that caused the eating disorder in the first place. The focus is on dealing with the stress factors which trigger the bulimic episodes, like underlying anxiety and depression, relationship issues, and feelings of isolation and loneliness.

Medication (SSRI anti-depressants) can also help in controlling the urges to binge and have been proven effective for the treatment of bulimia.

So, I would advise you to see a psychiatrist for a detailed psychological assessment and to start treatment as early as possible.

You should also aim at:
- Avoiding situations that trigger binges
- Learning to cope with stress in ways that don’t involve food
- Eat regularly to reduce food cravings
- Resisting purging (even if you have had a binge) - because purging will only reinforce further binging.
- Keeping yourself active and engaged as much as possible so that your mind is distracted from these unhealthy thoughts.

Wish you all the best.

Dr. Jonas Sundarakumar
Consultant Psychiatrist
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