Bulimia nervosa

We help you to balance body and mind

Bulimia is an eating disorder where the person experiences impulsive urges to eat and regularly participates in compulsive binge eating. This is often followed by unhealthy compensatory behaviours to prevent weight gain. Commonly these may include self-induced vomiting and or use of laxatives/diurectics also known as ‘purging’.

At Schoen Clinic we have years of experience in treating bulimia. We are able to offer intense support and treatment in our day programme which is led by a psychological therapist and specialist consultant psychiatrist. Regaining healthy eating and improving your self-esteem are essential to addressing bulimia.

Making the connection between your physical and mental health is an important part of your recovery from bulimia; psychoeducation, psychological therapies and understanding triggers can help you achieve mind and body balance. We will also help you develop skills for managing intrusive negative thoughts and poor impulse control through a variety of group and individual sessions.

Bulimia: Causes & symptoms

There are many reasons which may start you believing you need to control your weight and it may build up gradually before it becomes a cycle of binge eating and unhealthy behaviours. You may feel these eating behaviours achieve weight loss or a sustainment at a certain level of weight.
You may start to have impulsive eating habits where you crave food and feel a compulsion to binge with large amount of food. Following this, you may feel a number of negative feelings and thoughts which lead you to ‘purge’. Feelings such as guilt, self-disgust, embarrassment, anxiety, despair, fear and a negative spiral of deprecatory self-talk.

Compensatory behaviours

Compensatory behaviours can include:

Self-induced vomiting
Laxative misuse
Diuretic misuse
Misuse of other medications (e.g. diet pills, insulin)
Fasting or significant dietary restriction
Excessive exercise

Other symptoms of bulimia

There are further symptoms that are associated with bulimia, which may include the following:

Binging on food that one would normally avoid
Restrictive eating or dieting outside of binge eating episodes
Secrecy of binge eating due to shame
Fluid disturbances, sometimes leading to oedema (fluid retention shown as swelling)
Dehydration
Electrolyte disturbances from repeated purging behaviours
Gastrointestinal symptoms e.g. bloating and constipation
Dental issues
Significant impact of shape and weight on self-esteem
Being within a healthy weight range, or overweight

How does bulimia develop?

As with other eating disorders, there is no one definitive cause of bulimia. However, there are certain risk factors that can increase the likelihood of developing bulimia.

Low self-esteem
Depressive symptoms
Childhood anxiety
Weight concerns based on the thin ideal body type
Experience of trauma, including abuse
Childhood obesity
Early puberty
Genetic vulnerability shown by a family history of eating disorders or other mental health disorders

Diagnosis: How we identify bulimia?

A full assessment is provided to identify your diagnosis, needs and treatment goals. Bulimia is different for every person and how it affects your life can be mild to extreme. The level it impacts on you will determine the right treatment programme. We use a number of assessment tools that support a diagnosis of bulimia and will also assess your physical health which can be clear indicators of binging and purging behaviours.

Permanently regain healthy eating habits

We know that good mental health has an impact on your physical wellbeing and vice versa. When you feel physically compromised your mental wellbeing suffers. We will address both your physical and mental health in a holistic way. By this we mean that we will ensure that we look at every aspect of your life, your relationships and your relationship with food. To offer you a new perspective on life, at Schoen Clinic we take medical, psychological and social factors into account in your treatment. Consultant psychiatrists, clinical psychologists, and therapists work together to support you in managing stress and permanently regaining healthy eating habits.

Treatment for bulimia supports you to establish regular eating habits that reduce the urge to binge eat. We understand that this can be challenging, especially where there is body image concern and a fear of weight gain. At the same time as helping you to change your eating pattern, we give you the tools and the confidence to challenge some of the thinking patterns that kept the bulimia going, and to manage your emotions differently.

For most people, outpatient treatment for bulimia is effective and they do not need more intensive treatment.

Outpatient treatment

This usually consists of around 16 sessions of weekly cognitive behavioural therapy focused on your eating disorder (CBT-E). For some people, especially where there is self-harm or trauma, dialectical behavioural therapy or psychodynamically informed eating disorders therapy may be more helpful.

Day care for bulimia

Our day care programme offers more intensive treatment. It is suitable for people who have not been able to make progress as an outpatient, or who are very unwell with bulimia, e.g. with physical complications.

In our day programme, we focus on individual therapy, physical healthcare, nutritional management, group interventions and mental health and wellbeing.

Individual psychological therapies

Our specialist therapists will work with you to increase your knowledge and understanding of how you connect to yourself and others. We work with you to discover deep rooted issues that influence how you see yourself and relate to others, and help you develop more constructive and empowering perspectives. Psychodynamic and behavioural approaches such as Cognitive Behavioural Therapy are offered in our services.
We will support you and your families, where relevant, to develop new insights and approaches that will benefit you.

Physical healthcare

Where indicated as required, we will monitor your physical health on a regular basis and will help you to seek the appropriate medical help you need in a timely and supportive manner as is necessary.
Making the link to your physical wellbeing and your mental health is important for you to understand how Bulimia can affect you. Especially if you engage in regular purging behaviours or restrict yourself from eating a regular meal which then leads to binging.

Nutritional management

We understand how important nutrition is for healthy day to day functioning and therefore will provide you with psychoeducation , dietician advice and regular supervised meals that promote positive change while supporting and reassuring you at every stage.

Group interventions: Supporting each other

Our skilled group facilitators will encourage you to explore how you connect and respond to others in a safe environment. Groups are particularly helpful in sharing positive experiences, skills, knowledge and supportive interventions. Group work is recommended so that you have the opportunity to explore how you relate to others and how they relate to you. Your feelings about yourself can be gently challenged by others who can relate to them and who have also experienced them.

Mental health and wellbeing

Your wellbeing is important and often when people are unwell, they neglect their creative, spiritual and sensory selves. We will encourage you to reconnect with these aspects of yourself through a number of supported activities. We teach and help you to utilise mindfulness, relaxation techniques and your own creativity. Sometimes our busy lives mean we neglect these areas and sometimes investing time in relaxing and focussing on your own wellbeing can seem wasteful. Therefore learning to appreciate personal reflection and also how quiet contemplative or guided meditations can remind you of the value of reclaiming time for you.

Meet the team

Our team of experts consist of consultant psychiatrists, clinical psychologists, therapists, dieticians, and specialist nurses who work together as a multidisciplinary team for the benefit of every patient in the treatment of bulimia.