Evidence for its efficacy seems mixed, although it anecdotally has helped people overcome bulimia. It can also help to reduce symptoms of other co-occurring mental health issues that may interfere with bulimia treatment.
What is Prozac?
Prozac’s active ingredient is the drug fluoxetine.  This is an antidepressant used to treat several mental health conditions, including:
- Obsessive compulsive disorder (OCD)
- Some eating disorders (including bulimia)
- Panic attacks
It is in a class of medication called serotonin reuptake inhibitors (SSRIs), which change the way serotonin is absorbed in the brain. Serotonin is a key chemical that can affect mood and more.
When used correctly, these drugs can help a person maintain a better mental balance than their brain naturally achieves on its own.
How is Prozac Used in Bulimia Treatment?
Not all questions surrounding why Prozac and similar medications can help treat bulimia have been fully answered. In a review of studies of anorexia nervosa, a similar but admittedly still different eating disorder, researchers did explore some of these questions, and many of their answers also likely apply to bulimia nervosa. 
Can Prozac Treat Bulimia?
Medication alone generally can’t treat bulimia, but it can sometimes be helpful as a supplemental treatment.
A fairly early study in the 2000s 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. 
Notably, however, that review didn’t tend to find these results for AN-BP, which stands for anorexia of the binge-eating/purging subtype. At the same time, fluoxetine is approved to treat bulimia by the FDA.  Many experts and patients have found it helpful in the improvement of bulimia symptoms, with a recommended dosing of 60 mg per day for adults.
Antidepressants should generally not be used as part of bulimia treatment for young people. It’s also notable that SSRIs specifically are helpful, whereas tricyclic antidepressants and monoamine oxidase inhibitors aren’t recommended to treat bulimia, and bupropion is outright contraindicated.
Are Any Medications Specifically for Treating Bulimia?
No medication exists exclusively to treat bulimia or other eating disorders, with fluoxetine being the only medication approved for treating bulimia nervosa by the FDA.
Other medications may be used for mental health issues that often accompany eating disorders, such as obsessive compulsive disorder (OCD), depression, and panic disorders. Indirectly, medications that can help a patient control these disorders may also make it easier to get treated for bulimia successfully.
It’s unlikely that there will ever be a medication that “cures” bulimia, 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 bulimia or any other eating disorder. But, like other chronic conditions, bulimia can be effectively treated and managed for life despite there being no cure.
Fluoxetine works best when combined with other talk-based treatments designed to help patients learn to reconfigure how they view themselves and their eating. They can learn how to modify their behavior into healthier patterns in therapy.
What Makes an Effective Bulimia Treatment Plan?
An effective bulimia treatment helps a person achieve a sustainable pattern of healthy behaviors, such as eating a healthy diet and maintaining a healthy weight and body image, and avoidance of unhealthy behaviors, such as binge eating and purging.
Both adults and adolescents benefit from individual therapy, where a professional helps individuals pinpoint contributing factors to their bulimia. They may also benefit from joining a self-help support group where they can talk with others who are also in recovery.
Cognitive Behavioral Therapy
If this isn’t enough, they may also benefit from cognitive behavioral therapy (CBT), which involves working with a therapist to explore what drives them to engage in purging and other unhealthy behaviors related to bulimia. Then, they may work with a therapist to determine the best ways to modify their thoughts and behaviors to achieve a healthier lifestyle.
Younger people often benefit from family therapy, a form of group therapy where an individual and their immediate family talk with a therapist to figure out how bulimia has affected everyone and the best ways to help the person get better. Adults can also benefit from this therapy, especially if they live with a family that is largely supportive but don’t know the best ways to help. Since family members are often the most vital part of a person’s support system, family therapy can be crucial.
Medication can be helpful in the recovery process, although not generally for children. In addition to direct help, medicines may help a person manage certain conditions, such as anxiety, depression, phobias, and more, that are interfering with their recovery and/or hurting their quality of life.
- Walsh BT, Agras WS, Devlin MJ, Fairburn CG, Wilson GT, Khan C, Chally MK. (2000). Fluoxetine for Bulimia Nervosa Following Poor Response to Psychotherapy. The American Journal of Psychiatry; 157(8):1332-1334.
- Fluoxetine. MedlinePlus. (2022, January 15). Accessed September 13, 2022.
- Marvanova M, Gramith K. (2018). Role of Antidepressants in the Treatment of Adults With Anorexia Nervosa. The Mental Health Clinician; 8(3):127-137.
- Label for PROZAC (fluoxetine). U.S. Food and Drug Administration. (2017, January). Accessed September 13, 2022.
- Treatment – Bulimia. (2020, November 10). UK NHS. Accessed September 13, 2022.