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Log in through your institution journal article Bulimia Nervosa: Antidepressant Or Cognitive Therapy Is EffectiveBMJ: British Medical Journal Vol. 300, No. 6723 (Feb. 24, 1990) , pp. 485-487 (3 pages) Published By: BMJ https://www.jstor.org/stable/29707006 Read and download Log in through your school or library Alternate access options For independent researchers Read Online Read 100 articles/month free Subscribe to JPASS Unlimited reading + 10 downloads Journal Information The BMJ is an international peer reviewed medical journal and a fully "online first" publication. Our publishing model–"continuous publication"– means that all articles appear on bmj.com before being included in an issue of the print journal. The website is updated daily with the BMJ's latest original research, education, news, and comment articles, as well as podcasts, videos, and blogs. All the BMJ's original research is published in full on bmj.com, with open access and no limits on word counts. We do not charge authors or readers for research articles, nor for other articles arising from work funded by open access grants. The BMJ's vision is to be the world's most influential and widely read medical journal. Our mission is to lead the debate on health and to engage, inform, and stimulate doctors, researchers, and other health professionals in ways that will improve outcomes for patients. We aim to help doctors to make better decisions. The BMJ team is based mainly in London, although we also have editors elsewhere in Europe and in the US. Digitization of the British Medical Journal and its forerunners (1840-1996) was completed by the U.S. National Library of Medicine (NLM) in partnership with The Wellcome Trust and the Joint Information Systems Committee (JISC) in the UK. This content is also freely available on PubMed Central. Publisher Information Vision – To be the world's leading and most trusted provider of information and services that will make a real difference in clinical practice and improve outcomes for patients. Mission – To lead the debate on healthcare and to deliver innovative, useful evidence based knowledge, best practice and learning to doctors, other health professionals, researchers and patients when and where they need it. We publish a number of journals covering major specialties and a growing number of online products for doctors and patients. Continuous product development ensures that our products and services are of constant importance to the medical profession. The BMJ Publishing Group Ltd (BMJPG) is the innovative publishing division of the British Medical Association (BMA) and is one of the world leaders in medical publishing. The BMJ Group complements the activities of the BMA. Rights & Usage This item is part of a JSTOR Collection. DiagnosisIf your primary care provider suspects you have bulimia, he or she will typically:
Your primary care provider may also request additional tests to help pinpoint a diagnosis, rule out medical causes for weight changes and check for any related complications. TreatmentWhen you have bulimia, you may need several types of treatment, although combining psychotherapy with antidepressants may be the most effective for overcoming the disorder. Treatment generally involves a team approach that includes you, your family, your primary care provider, a mental health professional and a dietitian experienced in treating eating disorders. You may have a case manager to coordinate your care. Here's a look at bulimia treatment options and considerations. PsychotherapyPsychotherapy, also known as talk therapy or psychological counseling, involves discussing your bulimia and related issues with a mental health professional. Evidence indicates that these types of psychotherapy help improve symptoms of bulimia:
Ask your mental health professional which psychotherapy he or she will use and what evidence exists that shows it's beneficial in treating bulimia. MedicationsAntidepressants may help reduce the symptoms of bulimia when used along with psychotherapy. The only antidepressant specifically approved by the Food and Drug Administration to treat bulimia is fluoxetine (Prozac), a type of selective serotonin reuptake inhibitor (SSRI), which may help even if you're not depressed. Nutrition educationDietitians can design an eating plan to help you achieve healthy eating habits to avoid hunger and cravings and to provide good nutrition. Eating regularly and not restricting your food intake is important in overcoming bulimia. HospitalizationBulimia can usually be treated outside of the hospital. But if symptoms are severe, with serious health complications, you may need treatment in a hospital. Some eating disorder programs may offer day treatment rather than inpatient hospitalization. Treatment challenges in bulimiaAlthough most people with bulimia do recover, some find that symptoms don't go away entirely. Periods of bingeing and purging may come and go through the years, depending on your life circumstances, such as recurrence during times of high stress. If you find yourself back in the binge-purge cycle, follow-up sessions with your primary care provider, dietitian and/or mental health professional may help you weather the crisis before your eating disorder spirals out of control again. Learning positive ways to cope, creating healthy relationships and managing stress can help prevent a relapse. If you've had an eating disorder in the past and you notice your symptoms returning, seek help from your medical team immediately. Clinical trialsExplore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. Lifestyle and home remediesIn addition to professional treatment, follow these self-care tips:
Alternative medicineDietary supplements and herbal products designed to suppress the appetite or aid in weight loss may be abused by people with eating disorders. Weight-loss supplements or herbs can have serious side effects and dangerously interact with other medications. Weight-loss and other dietary supplements don't need approval by the Food and Drug Administration (FDA) to go on the market. And natural doesn't always mean safe. If you choose to use dietary supplements or herbs, discuss the potential risks with your primary care provider. Coping and supportYou may find it difficult to cope with bulimia when you're hit with mixed messages by the media, culture, coaches, family, and maybe your own friends or peers. So how do you cope with a disease that can be deadly when you're also getting messages that being thin is a sign of success?
Get supportIf you have bulimia, you and your family may find support groups helpful for encouragement, hope and advice on coping. Group members can truly understand what you're going through because they've been there. Ask your doctor if he or she knows of a group in your area. Coping advice for parentsIf you're the parent of someone with bulimia, you may blame yourself for your child's eating disorder. But eating disorders have many causes, and parenting style is not considered a cause. It's best to focus on how you can help your child now. Here are some suggestions:
Remember that eating disorders affect the whole family, and you need to take care of yourself, too. If you feel that you aren't coping well with your teen's bulimia, you might benefit from professional counseling. Or ask your child's primary care provider about support groups for parents of children with eating disorders. Preparing for your appointmentHere's some information to help you get ready for your appointment, and what to expect from your health care team. Ask a family member or friend to go with you, if possible, to help you remember key points and give a fuller picture of the situation. What you can doBefore your appointment, make a list of:
Some questions to ask your primary care provider or mental health professional include:
Don't hesitate to ask other questions during your appointment. What to expect from your doctorYour primary care provider or mental health professional will likely ask you a number of questions. He or she may ask:
Your primary care provider or mental health professional will ask additional questions based on your responses, symptoms and needs. Preparing and anticipating questions will help you make the most of your appointment time. How does serotonin affect bulimia?Physiologic and pharmacologic evidence suggest that patients with normal weight bulimia have reduced serotonin activity when acutely ill. Such disturbances, even if secondary to dietary abnormalities, may still contribute to dysphoric mood and binging behavior.
Which antidepressant is contraindicated in bulimia?Bupropion is contraindicated because of the increased risk for seizures; patients should also be warned against its use for smoking cessation. Finally, drugs that can increase appetite or cause weight gain (e.g., olanzapine, mirtazapine, paroxetine) are not recommended.
Can antidepressants help with overeating?Antidepressants may help reduce binge-eating episodes in one of a few ways. Lower-than-normal levels of chemical messengers in the brain, such as serotonin, dopamine, and norepinephrine may affect appetite, mood, and impulse control. This can contribute to binge eating.
What are five effects that bulimia nervosa may have on the body?anemia.. low blood pressure and irregular heart rate.. dry skin.. ulcers.. decreased electrolyte levels and dehydration.. esophageal ruptures from excessive vomiting.. gastrointestinal problems.. irregular periods.. |