Using Prozac to Treat Bulimia: Research & Effectiveness 

Sometimes, medication becomes part of someone’s treatment plan. There are very few medications currently approved to treat eating disorders, but many can help with symptoms or conditions that work to maintain BN, including depression, anxiety, or obsessive-compulsive disorder (OCD).

Currently, Prozac is the only antidepressant specifically approved for the treatment of bulimia nervosa.³ While research on its efficacy is ongoing, anecdotally, the drug seems to have helped many people overcome the symptoms of bulimia.

What is Prozac?

Prozac is a type of medication called a selective serotonin reuptake inhibitor (SSRI). It’s primarily used to help people better regulate their moods and emotions.

Serotonin is an important hormone in the body, responsible for a number of functions, including helping with mood, sleep, and appetite regulation. Once released into the bloodstream, the chemical is eventually absorbed into nerve cells in a process known as “reuptake.” SSRIs work by blocking or inhibiting this process, making more serotonin available to the body and brain.⁴

When used correctly, fluoxetine can help restore a better balance of chemicals in the brain, making it easier for someone to regulate or control their mood. It may also make it easier for people to work through other types of treatment, including talk therapy programs.⁴

Prozac, Bulimia, and Eating Disorder Treatment

Medication is very rarely if ever, used as a first-line treatment for bulimia nervosa. By and large, treatment teams prefer psychotherapy as a way to address the underlying mental health complications that drive eating disorders. But for some people, Prozac can be helpful as a supplemental treatment. 

Research has suggested fluoxetine, the drug that makes up the brand name Prozac medication, was helpful as an intervention for patients who did not respond adequately to psychotherapy alone.¹ That may be because it can help reduce symptoms of depression, anxiety, or other issues that may interfere with treatment.

Studies examining the use of Prozac for binge eating disorder also found that the drug helped reduce binge eating episodes.⁵ It’s possible it may have the same effect on people with bulimia nervosa.

How is Prozac Used in Bulimia Treatment?

When someone is receiving treatment for an eating disorder, they’re likely involved with a treatment team made up of experts from a range of disciplines. This can include nurses, primary care physicians, nutritionists, eating coaches, medical specialists, therapists, and psychiatrists, among other professionals.

If a member of the treatment team thinks medication may be appropriate, they will likely have the patient speak with a psychiatrist—a mental health specialist who is licensed to prescribe medication. The psychiatrist will interview the patient about their past and present struggles and may run a few tests, such as blood tests or CAT scans. If they also feel it’s appropriate, they’ll then prescribe Prozac for the patient.

Once taking the medication, the patient will have regular check-ins with their psychiatrist to monitor effectiveness, look out for potential side effects, and fine-tune dosage. The psychiatrist will also inform other members of the treatment team of these updates, and they may adjust their treatments accordingly. Otherwise, there will be no major changes to the treatment program. A patient will continue to go to psychotherapy, group therapy, nutritional education, and any other sessions that are part of their plan.

Prozac must build up in the bloodstream to be fully effective, which can take anywhere from 2-6 weeks.⁷ In the first stages of taking Prozac, a patient may experience little or no change to their mood or eating disorder symptoms. Similarly, it’s generally recommended to wean off of fluoxetine. If a patient decides to go off Prozac, it’s important to do so with the help of a medical professional.

Are Any Medications Specifically for Treating Bulimia?

No medication exists exclusively to treat bulimia nervosa or other eating disorders. They’re typically used to treat co-occurring mental health disorders, such as depression, which work to drive bulimia symptoms. But fluoxetine is the only medication approved for treating bulimia nervosa by the FDA.³

Other medications may be used to treat mental health issues that often accompany eating disorders, such as obsessive-compulsive disorder (OCD), depression, and panic disorders. These medications tend to work indirectly by helping patients control co-occurring issues, which may make it easier for them to focus on BN treatment.

It’s unlikely that there will ever be a medication that “cures” bulimia nervosa, in the sense that a person takes it and needs no further treatment to control their symptoms and improve their health. There is no cure for BN or any other eating disorder. But, like other chronic conditions, bulimia nervosa can be effectively treated and managed for life.

What Makes an Effective Bulimia Treatment Plan?

An effective bulimia treatment program is often a multi-faceted approach, dealing with the various psychological, biological, and environmental factors that develop and maintain eating disorders.

As such, fluoxetine, tricyclic antidepressants, and other medications work best when combined with talk-based treatments, nutritional education, and other methods to help patients learn to reconfigure how they view themselves and their eating. The medication can make it easier to get the most out of therapy, where patients generally learn how to modify their thoughts and behavior into healthier patterns. 

Support System

Many patients also benefit from additional sources of support. A strong network of family and friends who are willing to listen and be there for someone can be extraordinarily beneficial, and patients can also find and forge these types of connections in support groups or group therapy.

In any case, the goal of bulimia treatment is to help someone create a sustainable pattern of healthy behavior, such as eating an appropriate quantity and variety of food, maintaining a positive body image, and avoiding disordered eating behaviors. With the right kind of help, it’s entirely possible to reach recovery.