Finding a Bulimia Treatment Center
Everyone eats too much from time to time. Thanksgiving turkey, Christmas pie, and 4th of July barbecue all seem to call out for feasting, and sometimes, it’s hard to know when to refuse a second helping of something so delicious.
However, when most people eat a little too much, they can blame the great taste of the food or the holiday that food celebrates.
There’s a small subset of people, however, who can’t control how much they eat. According to the National Association of Anorexia Nervosa and Associated Disorders, people like this binge on huge amounts of food several times a week. These people can be so disgusted with the amount they ate that they can try to remove that food through vomiting or purging.
This is bulimia, and it’s a serious problem. Thankfully, it’s also a problem that comes with a solution, as treatment programs can help affected people to pull together more appropriate eating plans for a lifetime of good health.
Bulimia is classified as a serious mental health disorder and recognized in the definitive guide for clinicians, the Diagnostic and Statistical Manual of Mental Disorders – 5.
The main hallmark of bulimia is bingeing. During a binge, a person will typically consume a large volume of high-calorie foods in a short period of time (usually in one sitting and up to 3,000 calories or more).
People report that they feel out of control and cannot stop themselves during a binge. After a binge, feelings of guilt or shame typically set in, and individuals feel great remorse for the behavior. At this point, individuals engage in compensatory behaviors – purging activities – to rid their bodies of the calories consumed. Purging can take different forms, including self-induced vomiting, starvation for a limited period of time, over-exercising, and/or using laxatives or enemas.
Surveys show a rate of approximately 1.5 percent of the US female population and 0.5 percent of the male population has experienced bulimia in their lifetimes. These percentages translate to 4.7 million females and 1.5 million males. Although bulimia primarily affects adolescents and young adults, there are reports of this disorder occurring in a person as young as 6 years old as well as senior citizens.
Among men, research shows that bisexual and gay men are at greatest risk of experiencing bulimia compared to men who identify as heterosexual. Athleticism can put males at an increased risk for bulimia. The risk is especially high for men who participate in sports that have a preference for lean body types or fixed weight requirements, such as wrestling and boxing.
There is an increased risk of suicide among individuals who have bulimia. In fact, suicide is the number one leading cause of death among people who struggle with bulimia.
One research study reviewed the cause of death across death certificates in the US for the study’s given time window and found a mortality rate of 3.9 percent for bulimia. The rate of fatalities that involved bulimia, or that were caused by this disorder, is likely to be higher because coroners may list an associated condition as the cause of death, such as cardiac arrest. Despite public awareness on the many hazards associated with bulimia and the imminent need for help, it is estimated that only one in 10 people with bulimia will receive treatment. Relapse occurs in 30-50 percent of cases; however, relapse is considered to be part of the recovery process and should not be considered a sign that recovery is not possible.
Symptoms of Bulimia
Bulimia affects a person’s body, mind, and spirit. Much attention is paid to the physical aspect of this disorder, in part because bingeing and purging is highly impactful and can even be life-threatening.
The following physical symptoms of bulimia provide insight into the many health dangers this disorder presents:
- Facial swelling
- Presence of blood in vomit
- Sore throat
- Scarring on hands
- Tooth decay
- Irregular heartbeat
- Dry skin
- Dizziness or feeling faint
- Red eyes or burst blood vessels (due to vomiting)
- For females, difficulty conceiving
- Diminished sexual drive
- Complications in childbirth
Bulimia has a strong psychological component. A person’s thought processes both cause and fuel this disorder. The following are some of the psychological symptoms of bulimia:
- Ongoing preoccupation with weight and body shape
- A chronic fear of gaining weight or constant worry about being “fat” or overweight
- Feeling out of control when bingeing
- Getting distorted feedback when looking in a mirror
- Moods determined by food intake levels
- Not wanting to eat in front of people or in public
- A preoccupation with people’s perception of one’s weight or body
- Feeling the need to hide one’s eating behaviors
- A desire to weigh oneself often
- Readings from the scale determining one’s emotions
Some of the behaviors associated with bingeing and purging have been discussed above. Facilitation of this disorder can involve traveling from one location to another to obtain food for the binge and finding a place, inside or outside the home, to engage in the binge. Individuals may even expose themselves to risks, such as going out late at night, even in a high-crime neighborhood, to get to an open restaurant or store. There are costs associated with bingeing as eating larger amounts leads to higher food bills.
On the purging side, if vomiting is the method followed, withdrawing to the bathroom after meals is a common occurrence. Out-of-pocket costs associated with purging include costs for diuretics, laxatives, and other elimination aids.
Maintenance of this disorder requires time, effort, and resources. Individuals who look at an average week may realize they are dedicating a disproportionately large amount of time to this disorder. This realization may alert a person to the need for treatment.
How Bulimia Manifests
ANRED suggests that about 4 percent of college-aged women have bulimia. Many men, teenagers, adults, and seniors struggle with this eating disorder, too. But the behaviors that support bulimia are often performed in secret, and that means people with this disorder may have years of dysfunction behind them before their families are moved to take action.
Bulimia is sometimes triggered by a traumatic event, according to the U.S. Department of Health and Human Services. Living through a natural disaster or enduring a personal attack can leave people feeling helpless and out of control. Binging on food can provide a sense of comfort that can be very appealing to someone going through a crisis. Purging can bring a little boost of euphoria these people might desperately need in order to get through the day. To someone like this, bulimia is part of the trauma coping mechanism process, although it’s usually not very effective in healing long-term pain.
Bulimia can also be sparked by culture. Young women who read fashion magazines or watch fashion shows on television can become convinced that thin means good and fat means bad. These girls might attempt very severe diets involving water, caffeine, and fruit. By the end of the day, these girls are so hungry that they’ll eat almost anything, and they might binge as a result. Purging is a way for these girls to get back on track with a diet.
Bulimia can also run in families, meaning that people who grow up watching an adult engage in bulimia can become adults who do the same thing. There may be genes involved in this transition, or the young people might just mimic the behavior and assume it’s normal.
Without proper treatment, bulimia tends to get worse. People may start by binging and purging just once per month, but they might then purge once per week or even once per day. In time, people like this might be drawn to purge every meal.
Serious Health Risks of Bulimia
Many of the risks associated with bulimia are linked to the methods people use in order to eliminate binged foods from their bodies. Relentless vomiting or daily laxative consumption is just not good for vital digestive systems or overall body function. In time, according to the National Eating Disorders Association (NEDA), people with bulimia can develop:
- Inflammation of the esophagus
- Rupture of the esophagus
- Tooth decay
- Electrolyte imbalances
- Heart failure
While many of these health consequences are linked to purging, people who simply binge on food without trying to get rid of it can also become very ill. These people can eat so much that they strain their body’s capacity to hold food. Stomach linings can stretch and swell, as can the throat. These delicate systems can even burst. People who binge can take in twice or three times the amount of calories they need, and that can lead to weight gain and/or obesity.
Obesity can lead to all sorts of health problems, including heart failure, diabetes, arthritis, and some types of cancer.
What Treatment Options Are There?
People with bulimia have several options open to them, when it comes to getting better and leaving this disease behind for good.
For example, some people choose to enroll in inpatient programs that allow them to move into the treatment facility for a short period of time, so they can really focus on getting better for good. Others choose to enroll in outpatient care, so they can continue to work and interact with loved ones and their communities as they heal.
No matter the format of treatment, most people with bulimia need therapy. It’s here that people have the opportunity to really examine how the illness came about and what should be done in order to make things better.
Typically, the therapy follows a cognitive behavioral format, in which people with bulimia are asked to:
- Identify the situations or thoughts that trigger an urge to binge or purge
- Develop escape routes they can use in order to avoid these triggers
- Build skills they can employ when the trigger can’t be avoided
- Practice healthy self-talk and self-care, so triggers become less enduring
Often, according to analysis by the American Psychological Association, people with bulimia respond to the work in just 6-8 sessions. That means they learn very quickly, and they find they can put the lessons to good use almost immediately. But some people just don’t see the benefit of therapy like this. Thankfully, there are other approaches that can also assist with a bulimia problem, and when early therapies don’t bring relief, therapists can try those alternates instead.
Medications might also be helpful. According to Mayo Clinic, the medication fluoxetine has been approved by the U.S. Food and Drug Administration for the treatment of bulimia. This antidepressant medication seems to soothe electrical impulses in the minds of some people with bulimia, and this allows them to handle the demands of the eating disorder with a little more poise and grace.
As they work through their sessions and amend their eating habits, they might need a little encouragement from the people they trust, love, and know well. The more families can stay involved with healing, the better.
An outpatient program for bulimia provides people with counseling, medication support, and/or ancillary services (like exercise and nutrition counseling), while people continue to live at home. People in an outpatient program do not need to move into the facility in which they will get care. Instead, they can continue to live at home, as long as they keep their treatment appointments.
This form of care is typically suggested for people with mild or new cases of bulimia. People like this need help in order to get better, but they may not have such intense symptoms that they require the assistance of a staff that is available around the clock. These people may be able to stay healthy and on track, even while they are living at home.
People in an outpatient program might rely on their family members for help, and according to the National Alliance on Mental Illness, these concerned family members can be an amazing source of support for someone with bulimia. These people will need to have an abundance of both patience and kindness, and they’ll need to focus on providing assistance that is nonjudgmental. But when that community of people surrounds someone with bulimia, it makes sense to tap into the help by enrolling in outpatient care.
An outpatient program might also be a good choice for people who have reliable transportation and/or who live close to the treatment center in which they will be receiving care. Enrolling in outpatient means going to each and every appointment, without missing even one, and that can be hard for people who do not have the means to travel regularly. If people live close enough to treatment and/or they can get to appointments easily, outpatient programs might work.
Holding down a job provides some people with a real sense of accomplishment, especially since that job helps them to pay for the things their families need in order to stay healthy, happy, and fed. People who might be devastated to leave a job, even for the short time it might take to begin to recover from bulimia, might do better in an outpatient program, as they may still be able to work while they recover.
The National Eating Disorders Alliance reports that many people with eating disorders respond well to outpatient therapy. They get the care they need in these programs, and they gain the control they have been looking for, but these programs are not right for everyone.
When Inpatient Care Is Best
People with longstanding cases of bulimia might do a little better in inpatient programs. That might be due, in part, to the severe medical consequences this eating disorder can cause.
Some of these medical problems can be addressed with proper care. For example, kidney damage associated with bulimia is sparked, in part, by chemical imbalances caused by the excessive use of laxatives and vomiting. Those chemical imbalances could be addressed through diet, medications, or both.
People with bulimia may need these lifesaving interventions. If they do, it might be best to get those interventions within the walls of an inpatient treatment program.
Getting better also means steering clear of some very serious and persistent bulimia relapse triggers. Sometimes, those triggers can be lurking around every corner of a traditional American home.
For example, Mayo Clinic suggests that people working to overcome a bulimia issue will need to attend to issues of exercise. Many people with bulimia use exercise as a way to prompt weight loss, and as they recover, they may need to stop exercising altogether, or they may need to work with a trainer or some other professional, so they do not slip back into bulimia habits.
Someone living at home might be forced to walk by exercise equipment each and every day. Rowing machines, bicycles, and jump ropes might be a constant temptation, and they might be readily available within the home. Even a computer could be a temptation, as an exercise routine could be just a click away.
These sorts of temptations are just not available within a treatment program. The designers of these therapeutic programs work hard to ensure that there are no open triggers for people to slip and trip on. It can be a safer choice for people who face many triggers at home, or for people who do not have the willpower to handle the triggers they face at home.
Clinicians may also suggest, according to documents released by Priority Health, that people get inpatient care if they have lost a great deal of weight. A loss of weight of more than 15 percent of bodyweight in one month (if the person meets the criteria for obesity) could suggest that this person is using dangerous methods in order to lose weight. That might suggest that inpatient care is needed. Finally, some people need inpatient care due to severe psychiatric stress caused by bulimia. An article in American Family Physician suggests that some people with bulimia could become so upset and so distressed that they exhibit behaviors associated with suicide. They may talk about ending their lives, or they may talk about what the world would be like if they weren’t forced to live in it. That sort of talk is generally considered to be a medical crisis, and someone who discusses things in this manner might need inpatient help in order to stay safe.
This is not, by any means, an exhaustive list of everyone who needs inpatient care. The reasons for enrolling in an intensive program like this can be very personal, and they can be hard to explain to outsiders. Someone who simply feels unable to handle the demands of outside life and bulimia might do well to enroll in inpatient care, even if that sort of care isn’t typically recommended for people like that. The goal is healing, and people should use whatever means they think of as necessary in order to achieve that very real goal.
Bulimia Can Be Treated
With the right kind of help provided at the right time, people with bulimia can learn to amend their eating habits for the better.
When they do, they can come to a new understanding of what it means to live a healthy and happy life. By enrolling in quality treatment plans, all of those benefits can come about. American Addiction Centers does not treat bulimia; however, many respected facilities throughout the US do. It’s time for families to get started.
Tips for Bulimia Recovery
As you fight back against bulimia, try to:
- Focus on your therapy.
- Take medications as directed.
- Get enough sleep.
- Eat when hungry, and stop when full.
- Appreciate your body.
- Say “no” to diets.
- Be open and honest about your recovery.
- Be aware of the risk of relapse.
- Do things that make you happy.
- Plan ahead.