Bulimia Nervosa
Management and Resources
At home
When an individual is upset and/or confused about resolving their issues with binging and purging, it can be challenging to change their behavior. But making small tweaks to one's daily routine can improve recovery. Behavioral changes, when added to medications and therapy can be a powerful combination.
Self-compassion
Individuals with BN often have negative thoughts about themselves and their bodies. These thoughts over time can create a series of critical and negative thinking that lead one to hold themselves to different standards than they would of another. For example, one may look at someone and see an ideal body, and when they look at their own body (which objectively looks similar) will say harsh statements that they would never say to another. When one practices self-compassion and treat oneself like they would their best friend or partner, the “inner critic” becomes smaller and less judgemental over time.
Social support
Battling bulimia nervosa can be hard and social support can go a long way in the journey to recovery from BN. People with BN often need the help and support of family members and friends; however, sometimes it can be hard to accept the help and be vulnerable with others. Consider joining a support group or talking to a trusted friend. Try to surround oneself with body positive people (acceptance of all bodies) and avoid discussing weight and food with others. Be mindful of social media use and online support communities that might be triggering. Having a community of supportive people who only want the best for their loved ones, can make all the difference in one's treatment of BN.
Challenging beliefs and behaviors
Bulimia nervosa can cause people to believe negative thoughts and engage in behaviors they wouldn’t normally do. In treatment, they will be encouraged to challenge these thoughts and behaviors and it’s never too early to start. Try journaling to get to know oneself better and see if any trends are noticed in one's thinking or behaviors. Acknowledge any limiting ideas about one's body, weight, food, or what one should be like. Notice if one is engaging in any behaviors that only worsen feelings, like checking one's body in the mirror, over-exercising, or hiding under baggy clothes. Individuals should challenge themselves by reducing their exercise, avoiding mirrors for a day, or letting go of the belief that they have to look a certain way. Over time it will be easier to challenge oneself and make decisions based on core values, instead of what the BN may want.
At work and school
Bulimia nervosa tends to affect all parts of one’s life, including life at work and school. Individuals with BN do not need to tell anyone at work or school about having bulimia nor do they need to keep it a secret. The amount of information that one shares is their own choice, though some people find it useful to share that they are having a rough patch with a colleague or supervisor. Well trained managers and school administrators understand that individuals experiencing mental health concerns might need a modification in their work responsibilities for a period of time.
Find support: Having a friend, preferably at work or school, can lend many benefits. Getting the support of friends, family, and even online support groups can be a powerful way to listen to others and share one's stories in a confidential and dignified way.
Sometimes people with BN feel they are unable to work or attend school because they become too ill to perform basic daily work responsibilities or focus on their studies. Bulimia nervosa is an eating disorder that falls under the rules of the Americans with Disabilities Act. This means that if workers with BN can no longer perform all or most of their duties, then they are sometimes entitled to a medical assessment and potential accommodations.
Human resources at the place of employment may refer the individual to an employee assistance program for help or assist the employee in seeking workplace accommodations.
Students with disabilities are entitled to reasonable accommodations designed to help mitigate symptoms and increase their likelihood of academic success. Each school’s process of requesting accommodations may look different, so speaking with one's school administrator to understand their process and what documentation is required can be helpful.
In relationships
Bulimia nervosa can unfortunately have a negative impact on relationships in many ways. For example, most people are scared for their loved one when they observe binging or purging behavior, which is a key reason why people with BN try to limit their binges and purges to when they are alone. Due to such, many people with BN try to hide their behaviors and may even isolate. Eventually, loved ones may notice the behavior and talk to their loved ones and encourage them to seek help.
Couples counseling can be a fantastic tool for improving relationship quality when one or more partners struggles with bulimia nervosa. It can help both parties empathize with the other, and to find ways to best support one another.
Organizations
National Institute of Mental Health
National Eating Disorders Association
International Association of Eating Disorders Professionals
International Federation of Eating Disorder Dietitians