Eating Disorders are not about food.

 

“We need to understand what a woman is saying when she uses her body to express difficult emotional issues. We need to understand why it is safer to say “I need to go on a diet” than “I feel hurt or upset or in conflict” Susie Orbach.

 

Bulimia was the first eating disorder to be characterised by recurrent binge eating. The Bulimic eats abnormally large amounts of food and then experiences a loss of control.. The person suffering from Bulimia engages in extreme weight-control behaviours to counteract the large intake of food. Some of these behaviours may include self-induced vomiting and/or laxative or diuretic use (purging) or severe dietary restriction and/or intense exercise.

 

A second syndrome of recurrent binge eating, namely” binge eating disorder” differs from Bulimia in that sufferers do not regularly engage in extreme weight control behaviours. Bulimia nervosa occurs in around 1% of young western women. Intensive psychological treatments have been developed for people with Bulimia.  A manualised form of CBT for bulimia nervosa (CBT-BN) has been developed by Fairburn and colleagues (1989) In this therapy, a range of cognitive behavioural procedures are used in a specific sequence of tasks and experiments. Treatment is out-patient based and involves 15-20 sessions over about five months. There has been positive evidence from controlled studies that CBTBN is an effective approach in the treatment of bulimia nervosa, although it has also been found that  for some people  it is too intensive, while for others it is not sufficient.

 

A graduated intervention approach to the treatment of those with bulimia nervosa and binge eating disorder, has received empirical support from research by leading investigators in eating disorders. In this approach, the patients are offered psychoeducation or self-help therapies

and then re-evaluated for further treatment as appropriate. Self-help therapy is based around a manual that includes educative material and a version of the CBT-BN manual.

 

Other psychotherapies have been less frequently evaluated in the treatment of bulimia nervosa. However, there has been recent interest in interpersonal psychotherapy (IPT) and dialectical behaviour therapy (DBT) as alternatives to CBT.

Cognitive Therapy was initially developed as a treatment for depression by Psychiatrist Aaron T Beck. It has now become popular for the treatment of a wide range of psychological disorders.
Its guiding principle is that while we cannot control what life throws at us we can choose how we react to the situation or event. Beck believed that   we can change how we feel by changing what we think. The CBT therapist will focus primarily on the here and now and not so much on past issues.
People with Eating Disorders tend to have distorted thinking in relation to food and body image.

Typical Bulimic thoughts might be:

“I ate a bag of chips today and I feel like I have gained 5 inches on my hips”
I shouldn’t have eaten that Chinese take away now I have to throw it up”
I will only eat breakfast today so I can lose the extra fat I put on yesterday.
I know I look huge in these jeans and no one can tell me any different, I have to get down to a size 6 and then I will feel happy”.
If I lost 10 more pounds he will love me”
These examples illustrate that a negative thought  is instantly translated into feeling fat.

The challenge for the person with Bulimia is to become more aware of your negative self beliefs.
 Identify how these negative thoughts are making you feel (i.e. shame, guilt, anger, sadness) and how these feelings can lead you to a binge.  

This is the Thought/ Feeling /Behavior cycle.  

People with Eating Disorders tend to have other related difficulties in their life such as anxiety, depression, communication problems (social phobia), high stress levels and unexpressed anger. CBT can help to resolve these problems effectively.

CBT is not a magical cure and does involve the person with the problems becoming actively involved in the therapy. People coming for therapy for the first time tend to think that the model of therapy or the therapist is going to do all the work.
 
One of the major benefits of CBT is increased Self esteem:
Working with Self Esteem in CBT will involve focusing on the following:

Self awareness- becoming more aware of thoughts, feelings and behaviour.
Self acceptance- positive as well as negative aspects of the self.
Self care- recognising and meeting own needs.
Self protection- avoiding dangerous situations.
Self reliance/trust- making own decisions.
Self Assertion.
Self responsibility- taking responsibility for own actions.
 

Bulimia Nervosa, most commonly known as bulimia, is an eating disorder in which an individual engages in recurrent binge eating followed by feelings of depression, guilt, and self-condemnation. An individual who suffer from this type of eating disorder usually purge to compensate for the excessive eating and try to prevent weight gain. Purging can take the form of vomiting, inadequate use of laxatives, enemas or excessive physical exercise. This disease is mainly found in women aged from 16 to 40, but it most commonly starts around the age of 19. However, at times it develops in men and children as well.

 

In last few years, the ratio of people suffering from Bulimia Nervosa has increased proportionately. In fact, according to recent studies, it is even predicted that the number of people suffering from Bulimia eating disorder is two to three times as much as the number of people currently living with AIDS. Apart from this, it has also been found that Bulimia also affects different organs. The longer an individual suffer from Bulimia the more organs get affected and damaged. The organs that generally suffer are kidney, heart, digestive system, bones, endocrine glands and even brain. Certainly, these are only some alarming indications that clearly point towards the seriousness of Bulimia Nervosa. Thus the simple and best way to prevent from dangerous effects is to treat this eating disorder sooner rather than later.

 

Different ways to cure Bulimia Nervosa

 

There are many ways to treat Bulimia. However, looking at the present scenario psychological therapy and nutritional counselling are two most popular ways that are gaining worldwide acceptance. Psychotherapy has really turned out to be effective and long lasting treatment for an eating disorder like Bulimia Nervosa. During this type of treatment, the therapist not only addresses the eating disorder itself but help the sufferer by underlying reasons for why the individual is behaving in this manner. This behaviour is usually caused by psychological, interpersonal, and cultural influences and forces.

Nutritional Therapy is yet another way to treat Bulimia Nervosa. In this type of therapy, dieticians and other health care providers offer information about a healthy diet. At times, they even help in designing a proper eating plan to achieve a healthy weight and healthy-eating habits. Depending upon the chart prepared, the person's progress is monitored such as weekly weighing. Though this type of treatment takes time for curing eating disorder but has gained considerable importance. 

The next way of treatment is Group Therapy. As the name suggest, in this type of therapy a sufferer is supposed to get ongoing support and help from other sufferers and a group leader. But this way cannot be very helpful every time. At times, it can truly become harmful to many sufferers. The reason is that in group, patients frequently get worse or connect in more symptoms just to get extra attention from each other or the therapist.

Apart from all this, outpatient therapy is yet another type of therapy where a sufferer is allowed to go home after each session. Today there are many people who are responding to this type of therapy very well. This type of therapy gives them a feeling of security being in a home environment. Though, this type of treatment program largely demands a family care. In this type of treatment, it is important that the family cautiously watch and taka care of the sufferer while he or she is at home and ensure there are no bingeing and purging.

Certainly, with so many types of treatment options and therapies available, an individual can easily cure Bulimia Nervosa. Though for some, the condition become lifelong battle. As a result, it is important for an individual suffering from this type of eating disorder get instant treatment.