I want to recover from my eating disorder and need to learn how

Originally Published: June 17, 2005 - Last Updated / Reviewed On: March 10, 2015
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Dear Alice,

I have been bulimic for 6 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 student at Columbia College starting this September, but I don't want to wait that long. I want help now.

Dear Reader,

It is understandable that you feel eager to get better and frustrated with the idea that you have tried to quit many times, and that it hasn't worked. It isn't clear if you have tried to quit on your own, if you have been in a program, or have gotten the help you need. Bulimia is a serious eating disorder that needs intensive long-term treatment to overcome. Healing takes time, as well as support, skills of a clinician, and your own involvement each day. The clinician will assess which level of care is appropriate for you.

Although the eating disorder may not disappear immediately, what needs to be done immediately is intervention. And you want it now.

Your pediatrician or family doctor may be able to help you find an in-/outpatient program in your area for intensive treatment before the semester begins. Then you can receive follow-up treatment when you begin college, and be referred to an outside provider for long-term care, if necessary. Websites such as www.eating-disorder.com are designed as "treatment finders" and may guide you towards programs near you.

Although bulimia is difficult it is to treat and change, it is not impossible. Since the causes of bulimia are so complex, effective treatment requires a multidisciplinary team of professionals who specialize in eating disorders treatment. The team will address the medical, psychological, psychiatric, and medical nutrition needs of the person with the eating disorder. Because persistent vomiting erodes tooth enamel, dental care also needs to be a part of the treatment program. Your team will work with you to determine what method of treatment will work best for you, whether it be a combination of therapy and anti-depressant medication or cognitive-behavioral therapy,  group therapy and/or support groups or a combination of all of the aforementioned treatment options.

Some treatment options include:

  • Out-patient treatment programs are community programs set up for people with eating disorders who are more medically stable and are able to remain in their own environments during treatment without risk to their health. Hospitals that treat people with eating disorders may also have out-patient programs, but they may also be privately owned. Many universities also have multi-disciplinary teams that treat eating disorders.
  • In-patient/Residential treatment. While out-patient treatment alone is sufficient for the recovery of most people with bulimia, some individuals may require hospitalization or residential treatment. Extreme purging puts a tremendous strain on the body's organs, and drugs such as ipecac (used to stimulate vomiting), laxatives, and diuretics can be toxic when abused. Conditions warranting hospitalization include heart abnormalities, metabolic imbalances, substance abuse, clinical depression, or risk of suicide. A physician, nurse practitioner, or nurse can assess whether or not hospitalization is medically necessary.

Regardless of treatment modality, family therapy is a necessary aspect of the recovery process. The treatment team involves the person's family to help the family understand treatment goals, the eating disorder itself, and the functions it serves for both the person and family.

After the end of intensified treatment, on-going follow-up is extremely important with sustained contact between the person and those who work with the treatment program. Many people with bulimia benefit from participating in self-help or psychotherapy groups during their on-going recovery.

It's courageous and admirable of you 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 can find the treatment plan that is more likely to work, and can then begin to heal.

Alice