Bulimia nervosa

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Coping and support

By Mayo Clinic staff

You 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?

  • Remind yourself what a healthy weight is for your body.
  • Resist the urge to diet or skip meals, which can trigger binge eating.
  • Don't visit websites that advocate or glorify eating disorders.
  • Identify troublesome situations that are likely to trigger thoughts or behaviors that may contribute to your bulimia and develop a plan to deal with them.
  • Have a plan in place to cope with the emotional distress of setbacks.
  • Look for positive role models who can help boost your self-esteem.
  • Find pleasurable activities and hobbies that can help to distract you from thoughts about bingeing and purging.
  • Build up your self-esteem by forgiving yourself, focusing on the positive, and giving yourself credit and encouragement.

Get support
If 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 parents
If 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 it's better not to waste time trying to figure out why the eating disorder occurred. Instead, focus on how you can help your child now.

Here are some suggestions for supporting your child:

  • Ask your child what you can do to help. For example, offer to keep certain trigger foods out of the house. Ask if your teenager would like you to plan family activities after meals to reduce the temptation to purge.
  • Listen. Allow your child to express feelings.
  • Schedule regular family mealtimes. Eating at routine times is important to help reduce binge eating.
  • Let your teenager know any concerns you have. But do this without placing blame.

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 illness, you might benefit from professional counseling. Or ask your child's doctor about support groups for parents of children with eating disorders.

References
  1. Eating disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Jan. 17, 2012.
  2. Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4.. Accessed Jan. 17, 2012.
  3. Forman SF. Eating disorders: Epidemiology, pathogenesis and clinical features. http://www.uptodate.com/index. Accessed Jan 26, 2012.
  4. Ebert MH, et al. Current Diagnosis & Treatment: Psychiatry. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2008. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=10. Accessed Jan. 17, 2012.
  5. Forman SF. Eating disorders: Treatment and outcome. http://www.uptodate.com/index. Accessed Jan. 26, 2012.
  6. Breuner CC. Complementary, holistic, and integrative medicine: Eating disorders. Pediatrics in Review. 2010;31:c75.
  7. Carei TR, et al. Randomized controlled clinical trial of yoga in the treatment of eating disorders. Journal of Adolescent Health. 2010;46:346.
  8. Binge eating disorder. National Institute of Diabetes and Digestive and Kidney Diseases. http://win.niddk.nih.gov/publications/binge.htm. Accessed Jan. 31, 2012.
  9. LeGrange D, et al. Calculation of expected body weight in adolescents with eating disorders. Pediatrics. 2012;129:1.
  10. Sim LA, et al. Identification and treatment of eating disorders in the primary care setting. Mayo Clinic Proceedings. 2010;85:746.
  11. Interpersonal psychotherapy for depressed adolescents (IPT-A). National Registry of Evidence-based Programs and Practices (NREPP) Substance Abuse and Mental Health Services (SAMHS). http://nrepp.samhsa.gov/ViewIntervention.aspx?id=198. Accessed Jan. 26, 2012.
  12. Loeb KL, et al. Transdiagnostic theory and application of family-based treatment for youth with eating disorders. Cognitive and Behavioral Practice. 2012;1:17
  13. Hall-Flavin DK (expert opinion). Mayo Clinic Rochester, Minn. Feb. 22, 2012.
  14. Sim LA (expert opinion). Mayo Clinic Rochester, Minn. Mar. 14, 2012.
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