James Donaldson on Mental Health - What Is Bulimia Nervosa?

Challenges in treating bulimia One challenge in FBT for bulimia is that progress is more difficult to track than with anorexia, because it depends on reports from the patient regarding binge eating and purging episodes, corroborated by their parents, rather than a scale that reports weight gain.

The therapist depends on the patient accurately reporting the weekly count of bingeing and purging.

Sometimes the young person feels so embarrassed that they won’t acknowledge the true extent of their bingeing and purging.

“When that happens, the clinician needs to help parents share the real frequency of these behaviors without being critical,” notes Dr.

“They need language that they can use to express sympathy that the illness has gotten the hold of the young person in this way, rather than saying, ‘Oh, no, that is just blatantly untrue.

She vomited at least six times,’ and you can just hear the criticism rolling from the parents’ tongue.” Positive factors in treating bulimia What works in the favor of FBT for bulimia is that kids with the disorder tend to be less resistant to participation in treatment than those with anorexia.

Le Grange says, that’s because kids may actually want help to stop these behaviors that they find embarrassing and distressing.

This can give parents some leverage in the treatment process, and the child can help articulate how they think parents can best support their changing these behaviors.

Le Grange also notes that, for the most part, kids with bulimia tend not to be as emotionally impacted as those with anorexia.

For instance, “You don’t typically see someone with bulimia nervosa declining time with their friends or not wanting to go out anymore, isolating themselves.