How to effectively treat bulimia nervosa?

Anorexia nervosa must be treated scientifically and effectively because it can even be life-threatening. Treatments include medication and psychological therapy, including cognitive behavioral therapy and interpersonal psychotherapy.

1. Medication

The research on drug treatment of BN has progressed faster than that of AN. Commonly used drugs include antidepressants, anticonvulsants, etc., with the former being the main ones. Commonly used safe antidepressants are selective 5-HT reuptake inhibitors, and the anticonvulsants phenytoin and carbamazepine have mild anti-bulimic effects.

2. Psychotherapy

Most psychotherapy studies have found that psychological intervention is effective for BN, reducing the number of binge eating episodes and improving purging symptoms.

(1) Cognitive behavioral therapy (CBT) The goal of CBT treatment is to break the vicious cycle of binge eating and purging, control BN symptoms, and prevent relapse. The CBT method believes that regular eating is very important and uses behavioral techniques to reduce bulimia, including avoiding situations that are prone to binge eating, changing the way of thinking about the problem, teaching patients techniques to prevent relapse, etc., while using self-monitoring methods to record their own eating habits in detail.

(2) Interpersonal Psychotherapy (IPT)? Unlike the CBT method, IPT does not focus directly on the symptoms of BN, but focuses on and correcting "problematic interpersonal relationships." IPT aims to control and relieve symptoms by changing the way BN patients have interpersonal relationships. Therefore, IPT is slow to take effect and takes a long time. A series of comparative studies found that CBT is more effective than IPT at the beginning of treatment, and the symptoms of BN patients who subsequently underwent IPT continued to improve. Although CBT and IPT took different times to take effect, the two treatment methods were equally effective.

(3) Behavioral therapy (BT) There are many BT treatment methods. Exposure and response prevention (ERP) therapy is reported to be more effective for BN. ERP therapy is derived from the anxiety reduction model for treating obsessive-compulsive disorder. Most of the symptoms of BN patients were improved or even significantly improved after ERP treatment. Long-term follow-up studies have found that CBT and IPT are superior to BT, and BT patients are more likely to relapse compared with the first two methods.

3. Comprehensive treatment

In clinical work, in order to achieve the best therapeutic effect, a comprehensive treatment measure of psychotherapy combined with drug therapy is often used. CBT alone or combined with medication is more effective than medication alone. In addition, some patients also need physical supportive treatment, which stipulates the patient's meal time and food intake, minimizes or stops vomiting, and prohibits the use of cathartic drugs; symptomatic treatment is given to those with water and electrolyte metabolism disorders.