Bulimia

Bulimia is a cyclical eating disorder that is characterised by periods of overeating, followed by purging types of behaviour, or extreme exercise and dietary control. People experience a crisis or event that triggers the desire to eat which starts the cycle.

During the food intake people report feeling almost euphoric and happy, largely due to the chemical changes that the sweet, salty, fatty, high calorie and high carbohydrate foods create. It is not uncommon for individuals to consume as many as 5000 calories in less than an hour during a binge. Almost immediately guilt, shame, self-loathing and anger set in and create high levels of anxiety around the binging behaviour. This is typically followed by the abuse of laxatives, inducing vomiting, extreme exercise and excessively controlled food intake.

This becomes a cycle that, over time, will lead to serious mental and physical health risks. Treatment that includes both behavioural changes as well as understanding the emotional component of bulimia is the most effective in recovery and ongoing treatment.

Changing Behaviours by Changing Thoughts

One of the most important aspects of counselling in recovery and treatment of bulimia is changing thoughts about body image, weight and self-esteem. Individuals that are bulimic have a negatively distorted and highly critical view of themselves, especially as they appear physically. They may see themselves as overweight even though they are of average weight or even less than average weight.

The first goal of counselling is to develop a good understanding of what triggers the urge to binge eat. Identifying these triggers, which could include stress, change or anxiety over specific or general events, can then help the counsellor and the individual to develop more effective, healthy and positive coping skills. Nutritional counselling on healthy eating and healthy food choices may be introduced at this time in the process.

Attitude changes about physical appearance, weight loss or management and developing a realistic idea about weight are also a major focus of counselling. By changing the ways that food is viewed and by learning to modify these ideas a true change in eating habits can be developed.

Emotional Components

Throughout therapy the individual will be assisted, at their own pace and in their own time, to look at the deep emotional issues that have contributed to the negative feelings about self. For many individuals their unhappiness with themselves and the feelings of being out of control in the bulimia cycle can be linked to dysfunctional family issues, undiagnosed and untreated depression or anxiety or being isolated and alone. Treatment can include learning social skills to connect successfully with others, relationship counselling or working with counsellor to treat the underlying depression and anxiety.

Counselling to deal with the emotional issues and the negative thoughts that drive the behaviour in any eating disorder is critical to long term success and recovery. People can, through therapeutic interventions, change their thoughts and behaviours and develop positive, healthy self-esteem and self-confident to live a happy, satisfying and successful life.

Posted by: Philippe Jacquet