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Woman feeling unhappy

Bulimia’s Effects on the Face & Cheeks 

Bulimia can cause puffiness in the face as a result of purging, which can cause swelling in the parotid glands. While not dangerous, this swelling can sometimes cause pain and significantly affect a person’s facial aesthetic.

Most effective treatments for eating disorders

The Most Effective Treatments for Bulimia Nervosa

Bulimia nervosa (BN) is a serious mental health condition that can have dangerous and long-lasting impacts on physical, mental, and emotional well-being. It often manifests as cycles of binge eating and purging, which can lead to or support a number of other harmful symptoms.

Treating eating disorders like bulimia nervosa is possible through the right kind of support and care, along with patience and time. Many methods can help you or a loved one find recovery from bulimia nervosa.

Different Treatments for Bulimia

Like nearly all eating disorders, BN is a complex condition with a number of biological, psychological, and environmental factors working to develop and drive the eating disorder. A multi-faceted approach to treatment is often the best way to address these various issues.

Psychological Bulimia Treatments

Eating disorders like BN, anorexia nervosa (AN), and binge eating disorder (BED) manifest in very physical ways, but at their core, they’re mental health conditions. As such, psychological care is usually the primary method of bulimia treatment.

Some of the most common types of psychotherapy to help treat bulimia include:

Cognitive behavior therapy (CBT): Often considered the most effective treatment for bulimia nervosa, CBT helps people change unhelpful behavioral patterns by recognizing and changing the unhelpful thought patterns that drive them. Essentially, this structured course of treatment helps people “unlearn” harmful thoughts and learn new, healthier coping mechanisms.

Dialectical behavior therapy (DBT): Dialectical behavior therapy focuses on helping patients improve their emotional regulation, distress tolerance, and interpersonal relationships and cultivate a greater sense of mindfulness. It teaches that patients can simultaneously love and accept themselves while working to make helpful changes.

Acceptance and commitment therapy (ACT): Rather than focusing on thoughts that may be harmful, ACT teaches patients to let those thoughts go. The method uses mindfulness and other techniques that help encourage acceptance and encourages patients to direct their energy instead toward activities that align with their morals and make them feel good.

Physical Treatment for Bulimia

Since eating disorders like BN impact physical and mental health, treatment methods addressing physical ailments are also sometimes necessary.

This can be particularly true for people who utilize self-induced vomiting as a purging method, as this can have a major impact on oral health, causing tooth decay, dental erosion, and other issues that require medical attention.1

In severe cases, medical attention may also be necessary to help a patient in crisis reach medical stability. Most long-term treatments, including psychological care, are not administered until a patient is considered medically stable.

Nutritional Bulimia Treatments

Nutritional care is another keystone of bulimia nervosa treatment. Generally administered by a nutritional counselor, this type of treatment is largely educational, helping people learn more about nutrition and maintaining a healthy diet and eating habits.

Nutritional counseling aims to help patients learn how to maintain a healthy weight, get more in touch with their physical needs, and build a better overall relationship with their body. In some cases, counselors or other treatment team members may also provide meal support, eating with patients to help them feel more comfortable and safe during mealtimes, especially in early recovery.

Treating Bulimia Nervosa with Medication

Medications are generally not considered a first-line treatment for eating disorders, but some patients use them in tandem with psychotherapy. Medications can also be used as a way to help maintain recovery after treatment or help alleviate issues related to eating disorder behavior, such as anxiety or depression.

When treating bulimia nervosa in particular, selective serotonin reuptake inhibitors (SSRIs) can be helpful for some patients. This group of drugs generally helps with emotion regulation and has been found to help reduce binge eating behavior in some patients.2

What is the Most Effective Treatment for Bulimia Nervosa?

Every patient is different, with their own unique personal and medical history, psychological profile, and biological makeup, among other factors. That means that the most effective treatment for bulimia nervosa will look different for everyone.

Some patients may flourish with therapy, while others may do better with therapy and medication, and still others will rely more heavily on nutritional counseling and require other medical attention.

In general, however, cognitive behavioral therapy is considered the treatment of choice for BN. The method is also one of the most widely-researched treatment methods for bulimia nervosa, with a number of studies exploring its impact on healthy weight gain (when considered necessary), the reduction of binge eating behavior, and the improvement in important facets of mental health.3

Recently, an “enhanced” cognitive behavioral therapy method (CBT-E) has been developed, which incorporates the same techniques as CBT but addresses additional issues, such as low self-esteem, mood regulation, and perfectionism. Early studies show CBT-E may be an even more effective treatment for bulimia nervosa than cognitive behavioral therapy.4

Virtual Treatment for Bulimia

In an increasingly digital world, many of these treatments can now be administered online. Virtual eating disorder treatment is still relatively new, but studies have already shown it to be just as effective as in-person care, even in cases where patients require higher levels of care.5

Virtual treatment offers a number of benefits over in-person care, including the convenience of receiving care from home, greater flexibility when scheduling appointments, and the ability for patients who live in more remote or underserved areas to easily receive care. Remote programs are also generally less expensive than in-person programs, though this can vary from program to program.

Online care may not be the best choice for everyone, including patients with unstable home environments or little-to-no control over their disordered behaviors. But virtual eating disorder treatment can be helpful for most people who are struggling with eating disorders. Ask your healthcare provider if they think virtual treatment is a good choice for you.

Choosing the Best Treatment for You

When it comes to treating eating disorders, there is no “best” form of treatment, just the best treatment for you. The most effective bulimia nervosa treatment will depend on a number of very personal factors.

Speaking with a mental health professional is the best way to choose the best kind of care for you. These experts will be able to help issue an official diagnosis and determine a treatment plan that’s tailored to your personal history and needs.

Just remember to have patience. There are many ways to help someone recover from bulimia nervosa, and recovery is always possible.

Resources

Rosten A, Newton T. (2017). The Impact of Bulimia Nervosa on Oral Health: A Review of the Literature. British Dental Journal; 223:533–539. 

Sysko R, Sha N, Wang Y, Duan N, Walsh BT. (2010). Early Response to Antidepressant Treatment in Bulimia Nervosa. Psychological Medicine; 40(6):999–1005. 

Murphy R, Straebler S, Cooper Z, Fairburn CG. (2010). Cognitive Behavioral Therapy for Eating Disorders. The Psychiatric Clinics of North America; 33(3):611–627. 

Cooper Z, Fairburn CG. (2011). The Evolution of “Enhanced” Cognitive Behavior Therapy for Eating Disorders: Learning From Treatment Nonresponse. Cognitive and Behavioral Practice; 18(3):394–402. 

Van Huysse JL, Prohaska N, Miller C, Jary J, Sturza J, Etsell K, Bravender T. (2023). Adolescent Eating Disorder Treatment Outcomes of an In-Person Partial Hospital Program Versus a Virtual Intensive Outpatient Program. The International Journal of Eating Disorders; 56(1):192–202.

Orthorexia vs. Anorexia | Is There a Comparison?

Eating disorders are dangerous mental health conditions that impact many aspects of psychological, physical, and emotional health. And while every disorder can manifest in different ways for everyone, it’s important to know the differences between different eating disorders.

Person standing alone outside

Causes of Anorexia & How to Prevent It

Anorexia nervosa is a complex, serious mental health condition that has many contributing biopsychosocial—or biological, psychological, and social—causes. These can include hormones, genetics, co-occurring mental health challenges, and societal attitudes about food, weight, fitness, and health, among others.

Russell's sign

Effects of Bulimia on the Hands & Knuckles

Bulimia nervosa (BN) is an eating disorder that can cause significant wear on the hands and the knuckles specifically, resulting in something called Russell’s sign (also referred to as “bulimia hands”). This occurs primarily because of the incisors repeatedly grinding against the skin when a person induces vomiting.

Woman searching on her computer

How to Choose a Bulimia Treatment Program/Center 

Choosing a bulimia nervosa treatment program, or a program to help with other eating disorders like anorexia nervosa (AN) or binge eating disorder (BED), can feel like an overwhelming process.

Alternative holistic therapy

Alternative and Holistic Care for Bulimia

While many evidence-based treatments are often used to help people struggling with bulimia nervosa (BN), some types of alternative and holistic therapy may also be able to help.

Person in woods

How to Stop Emotional Eating

People eat food for any number of reasons, and not all of them have to do with physical hunger.

Patient speaking with a doctor

Bulimia Relapse: Signs and Prevention

Eating disorder relapse is common, whether you’re recovering from bulimia or any other eating disorder. While it may be a setback, it doesn’t mean you’re a failure. Each time you revert to disordered eating behavior, think of it as an opportunity to learn something you can apply if you feel yourself struggling again.

Interpersonal psychotherapy

Interpersonal Psychotherapy for Bulimia Nervosa

Interpersonal psychotherapy (IPT) is a form of talk therapy that has been shown to be potentially beneficial in helping people with eating disorders, including bulimia nervosa (BN).

Patient in doctor's office about mouth/jaw

Bulimia Jaw Pain and Swelling

You’ve probably seen photos of the so-called “bulimia jaw.” Before-and-after snaps can be striking, particularly if they show people with cheeks puffed up by repeated vomiting.

How to help someone with an eating disorder

How to Help Someone Who Has an Eating Disorder 

Watching a friend, family member, or loved one struggle with an eating disorder can be incredibly difficult. Though you want to help, you may be unsure how to help someone with an eating disorder.

Body image

Symptoms of Bulimia Nervosa | Body Image Negativity

Body image is an important aspect of how we see ourselves and can contribute significantly to our mental and emotional well-being.

Stomach issues

Bulimia & GERD: Causes, Signs & Treatment 

Bulimia nervosa (BN) is a serious eating disorder that involves cycles of binge eating and compensating for this behavior through fasting, over-exercise, self-induced vomiting, or other unhelpful actions.

Patient with a doctor

Am I Anorexic? Questions to Ask Yourself

If you are asking yourself, “Am I anorexic?” there’s a good chance you are. It can be helpful to know exactly what the eating disorder is and how to recognize the potential warning signs.

Patient speaking with a doctor

The Physical Side Effects of Anorexia (Short-Term & Long-Term)

Anorexia nervosa (AN) is an eating disorder characterized by an intense fear of gaining weight, severe food and caloric restriction, and a distorted body image.1

Anorexia vs. Bulimia: The Key Differences

Anorexia nervosa (AN) and bulimia nervosa (BN) are both serious eating disorders that impact mental, physical, and emotional health.

Bulimia Nervosa Treatment

Bulimia nervosa (BN) is a dangerous mental health disorder that requires appropriate care. And luckily, there are a number of therapies and treatments that can help.

Tips to Practice Healthy Eating 

When people hear the word “diet,” they may automatically think that the recommendations of the eating plan are healthy. But, in many cases, that’s actually far from the truth.

Types of eating disorders

How to Spot the Signs of an Eating Disorder 

The signs of an eating disorder can vary widely, depending on the type of eating disorder and the specific physiology, medical history, and present circumstances of the person.

Still, some signs are more common across all those factors.

Evidence-Based Eating Disorder Treatment

Thanks to several interlocking social, emotional, and biological factors that maintain and sustain them, eating disorders are often one of the most complex types of mental health conditions to diagnose and properly treat.

Eating disorder test

Eating Disorder Test | Do I Have a Problem?

Eating disorders are dangerous mental health conditions that can lead to a number of physical and emotional complications if left untreated. But determining when it’s time to seek treatment can be tricky.

Patient with a doctor

Levels of Treatment for Anorexia

There are many levels of anorexia nervosa treatment. Often, the best way to begin is by talking to an eating disorder specialist and determining what kind of therapy will work best for your health and circumstances.

Person struggling from an eating disorder

Signs of Anorexia—What to Look For

Anorexia nervosa (AN) is a serious eating disorder that impacts mental, physical, and emotional health. As such, it can have a range of signs and symptoms, impacting someone’s overall wellness and behavior.

Effects of not eating

The Effects of Not Eating

Periods of fasting have long been part of many religious, traditional, and cultural practices, but in recent years, the idea has become more widely adopted and used not as a spiritual tool but as a way to control diet and lose weight.

UnitedHealthcare Coverage for Bulimia Treatment 

UnitedHealthcare plans typically cover eating disorder treatment, including treatment for bulimia nervosa (BN). The company acknowledges the importance of eating disorder treatment on its site, highlighting the importance of getting care for these conditions.

Choosing an eating disorder therapist

Choosing an Eating Disorder Therapist, Program, or Rehab 

Eating disorders like anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) are complex mental health conditions that often require comprehensive care that takes someone’s emotional, physical, and mental health into account.

Cobra insurance coverage for eating disorders

COBRA Coverage for Bulimia Treatment 

The Consolidated Omnibus Budget Reconciliation Act, most commonly known as COBRA, is a law that allows you to extend insurance coverage after leaving your job. Whether you left your job because of voluntary or involuntary job loss, under COBRA, you can continue your insurance benefits through your former employer’s group plan for a specific time period.

Patient at doctor's office

Mental Side Effects of Anorexia

Anorexia nervosa (AN) is a serious eating disorder which can manifest in any number of ways, including as a variety of mental health concerns.

Treating eating disorders

How to Best Treat Co-Occurring Eating Disorders and Mental Illness or Substance Abuse 

Eating disorders like anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) are serious mental health conditions, but they rarely occur alone.