Dear Alice,

I have been bulimic for six years now. I have tried so many times to quit, but I always fail. When I eat I feel guilty about it sooo much that it is impossible not to purge. I feel so helpless. My boyfriend walked in on me the other day, and the look on his face broke my heart. I REALLY want to recover, but I need help. And I have no idea where to go. I will be a starting college this September, but I don't want to wait that long. I want help now.

Dear Reader,

Bulimia can be a serious and scary condition, but asking for help is a healthy decision and it sounds like you’re ready and motivated to make a change. The good news is that you don’t have to wait — a first step might be talking with your health care provider to help you determine the most effective treatment option(s) before the semester begins. Bulimia is a complicated condition and often the most effective way to treat it involves working with a team of health professionals to understand the different aspects of your disorder. Additionally, many universities have outpatient programs that include multi-disciplinary teams that specialize in treating eating disorders. This type of support may be a valuable resource for continued care when you transition back to school in the fall.

Regardless of whether you have tried to quit on your own or if you have been in a program, your frustration about not being able to quit is very common. Bulimia can be challenging to overcome, but it can be done — and you don’t have to do it alone. Treatment generally involves professionals such as psychologists, psychiatrists, social workers, dietitians, and/or health care providers. This may seem like a long list of professionals, but each one addresses a different aspect of health that may impact or be impacted by your condition. For example, if nutritional counseling is necessary, a dietitian can work with you to identify healthy food choices and work with you to establish a nutritious eating plan. In addition, the health professional team can create a personalized approach to treating bulimia, which could include various types of therapy (e.g., cognitive-behavioral therapy, group therapy, and/or support groups), antidepressant medication, or a combination of these options. Family therapy can also be a helpful aspect of the recovery process, as it helps the individual’s family understand the eating disorder and treatment goals, so they can provide additional support throughout this process.

Assessing how long you’ve been dealing with this issue and the severity of your case will likely determine the best type of program for you. Depending on your specific needs, there are a variety of programs set up to assist with disordered eating treatment, including outpatient and inpatient treatment programs. Outpatient treatment consists of community programs set up for people with eating disorders who are deemed medically stable and are able to remain in their own environments during treatment without risk to their health. While outpatient treatment alone is sufficient for many people dealing with bulimia, some may benefit from in-patient or residential treatment. Ideal candidates for in-patient treatment may be folks who have other conditions in addition to bulimia (e.g., depression or substance abuse) or those that may be caused by bulimia (e.g., severe dehydration or heart abnormalities). Regardless of your treatment method, follow-up contact with the health professional team has been shown to be beneficial for long-term recovery. If you want to learn more about disordered eating and different treatment avenues, the National Eating Disorders Association is a great resource for bulimia treatment options.

It takes a lot of courage to acknowledge that you need help and would like to recover. By taking these first steps, and by taking them in a measured, informed way, you will be on the path to finding a treatment plan that is most effective and begin the healing process.

Alice!

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