Treatment for Bulimia in Adult Men and Teenage Boys

A man with bulimia is compelled to eat large amounts of food, and when the binge is over, he can feel so guilty and/or disgusted with his behavior that he is compelled to use exercise, vomiting, or laxatives to purge the body of the meal.
Some men with bulimia go through these cycles of bingeing and purging several times each week, and they may not know how to gain control or stop the behavior.

For men like this, a bulimia treatment program can literally mean the difference between life and death. Families that present the benefits of a program like this in a clear, honest, and compelling way could help a man understand why he needs to enroll now, and what enrollment might look and feel like.

Breaking through Denial

breaking through denial While life with bulimia might be difficult, men who have the eating disorder may blame their discomfort and distress on some other aspect of life. For example, a study in the Science of Eating Disorders found that 26 percent of people with eating disorders thought there was nothing at all wrong with them, because they felt fine. Additionally, a full 80 percent of people with eating disorders thought that they did NOT have the disorder, because they associated eating disorders with extreme health issues. In other words, these people did not think they could be sick enough to qualify for an eating disorder.

This denial behavior is common for men with bulimia. This eating disorder has long been associated with women, so men may not know that they are even at risk of developing the disease. If they do understand their risk, these men may think that they are not ill enough or not disturbed enough to have the disorder. They may truly think that their behaviors are understandable, acceptable, and permissible.

A family can break through that denial and initiate treatment with an intervention. This is an open conversation about the real risks involved with continued bulimia habits, and here, a family can discuss how treatment works and why a man should get involved in treatment. Overall, this is a conversation that is characterized by love and understanding, held by a family that really wants things to get better.

But as Psych Central points out, people who are the focus of an intervention are sometimes, if not often, upset about this talk. They may lash out, grow upset, and deny the issue altogether. Families that continue to talk, and that accept denial for what it is, may be able to convince the person, in time, that the disorder is both real and treatable.

After a successful intervention, the family needs to help the person with bulimia to enroll in a treatment program. There are two types of programs that might be beneficial for men: inpatient treatment and outpatient treatment.

In an inpatient program, a man moves into the treatment facility in order to get comprehensive care around the clock. Typically, according to the National Eating Disorders Association, this form of care is recommended for people with severe eating disorder symptoms, such as:

  • Heartbeat irregularities
  • Electrolyte imbalances
  • Suicidal thoughts
  • An inability to stop the behaviors

These are people on the severe side of the bulimia spectrum, who face very serious risks of relapse or health problems if they continue to live at home or in some other unsupervised environment.

People like this need the shelter of inpatient care.

Outpatient care, on the other hand, could be a good option for people who do not have overwhelming health issues caused by bulimia, and who can lean on family members, friends, and community connections for additional support while healing. People like this still have bulimia, of course, but they may be able to use their homes, communities, and workplaces as healing sites between appointments with a provider.

One treatment type is not inherently better than another. For example, in a study in the journal Psychotherapy and Psychosomatics, researchers compared the efficacy of both treatment types in people who had bulimia, and no differences in response rates were found. Both types seemed able to provide the help people needed in order to get well.

The key is to ensure that the treatment setting chosen is right for the man who needs assistance with his bulimia. For some, inpatient care is the right choice. Others might flourish in outpatient care. Families can work with treatment providers and medical professionals in order to make a choice about which is right for the person they love.

Whether a man gets care in an inpatient facility or whether he gets care in an outpatient program, his treatment plan will likely progress on two fronts, with medications and therapy.

Bulimia can cause a great deal of physical damage, including distress that involves the:

  • Stomach
  • Esophagus
  • Heart
  • Kidneys
  • Liver
  • Skin

Medications might be used as part of a physical rehab program. A man might need vitamins or medications in order to ease his physical discomfort, so he can get on the right path to wellness. Or he might also need medications to soothe his mental distress.

An analysis in American Family Physician suggests that antidepressants could be a useful tool in the fight against bulimia, as they tend to soothe electrical connections and cause a dip in the urge to either binge or purge. People who take these medications for bulimia may or may not have symptoms of depression, but the medication seems to help them either way.

The type of therapy that is often provided in concert with medications is known as Cognitive Behavioral Therapy, according to England’s National Health Service. In this form of therapy, men with bulimia are encouraged to name the thoughts that enter their minds right before they feel a need to purge. Men are then given tools they can use to counteract those thoughts, so they do not binge or purge in response.

In addition to therapy sessions and medications, a man might be asked to work with a dietitian on a meal plan. Some men with bulimia develop long lists of foods that are considered “good” along with foods that are listed as “bad,” and they are unaware of how to break those lists down or why they should do so. A dietitian can help a man to understand the science behind the foods he eats, and a dietitian could help a man learn to identify feelings of hunger and satiety, so he can eat when hungry and stop when full.

An exercise physiologist might also provide help in some bulimia programs. Since men might use exercise as part of a purge, this professional can help men to understand what exercise is really designed to do and what a healthy program might look like. A man might walk away from these sessions with knowledge about how to incorporate exercise into everyday life, rather than using focused exercise as a method to lose weight.

Healing Times

While people with bulimia might be inspired to change with all the help they get in their treatment programs, it can take time to really overcome the challenges this eating disorder can cause. Often, that means bulimia treatment programs last for a very long time.

An article in the American Journal of Psychiatry suggests, for example, that people with bulimia are typically expected to remain in treatment for 4-5 months. When that work is through, men with bulimia might be asked to participate in outpatient settings for another few months, so slips in behavior do not take hold.
A man might be eager to drop out early or stop the work too soon. Families should work hard to keep the man engaged in the work, so he can make changes that last a lifetime. With their prompting, a man could get the relief he has been looking for and achieve a balanced, healthy life.

Disclaimer: Facilities in the American Addiction Centers family do not treat bulimia directly, but we can refer you to programs that can help, should you come to us for another issue.

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