Assisting A Loved One Through Treatment For Bulimia




The person restricting calories, bingeing, purging, or excessively exercising may become anxious about getting caught or irritable when accusing a loved one of being unfairly suspicious or “controlling.” — Lisa Ferentz LCSW-C, DAPA

When you find out that a loved one is suffering from bulimia it can be confronting and overwhelming. When this occurs, you will likely feel a strong urge to do anything that you can to support them. Supporting someone through treatment for an eating disorder can be taxing on yourself and will certainly take some effort on your part. However, if you are able to provide this support and understanding to them it might be that extra help they need to conquer the bulimia.

Having the conversation:


It can be very difficult to know where to start when supporting a loved one through bulimia, but having a conversation about your concerns is a good place.

  1. Research – Come to the conversation prepared, with a good understanding of what bulimia is and how it works. It is not simply just unusual eating behaviors based on body image issues and may often have a lot of emotions tied up with it. These can include strong feelings of shame, anxiety, embarrassment, guilt and even denial. Keep these in mind when approaching the conversation.


  1. Location – Choose a time and place where you can have a conversation in private and one where you are unlikely to be interrupted. Avoid places where there is a focus on food and try to choose somewhere that you know they will feel comfortable.

Because patients deny the severity of their condition they cannot accept the effects of malnutrition on heart, brain, organ and bone health. — Judy Scheel Ph.D., L.C.S.W., CEDS  

  1. Express your concerns – Keep in mind that they may not feel as though they have an eating problem or they might be very embarrassed by it. Try and approach it in a caring and non-judgmental manner. Be careful not to put any blame on them or criticize them as they may already be feeling embarrassed. This will only make them more defensive and unlikely to listen to you. Head on over to our other article (how to talk about bulimia) for some guidance around the type of language to use when having a conversation about bulimia.


  1. Encourage – Let them know that you are there to help support them in any way that you can. However, it is also important to encourage them to seek professional support (medical and psychological). You can certainly provide them support alongside their therapist, but this is not a battle that can likely be fought without therapy. Not only this but due to the severe medical concerns that can occur due to bulimia, it is important to get a doctor involved.


Model Good Habits:

Try and set a good example for your friend or loved one by focusing on healthy eating and balanced meals opposed to dieting or restricting food. Watch how you talk about appearance and body size, and avoid being self-critical and critical towards others.

Try and Boost Self-esteem:


Focus on the personality strengths that make your friend or loved one the wonderful person they are. Give them encouragement around these and emphasize these to them in conversation. This obviously has to be subtle. For example, if they expressed concern about their weight, you wouldn’t simply reply “but you’re a really nice person” as they will likely take this as a way to confirm their insecurity. Rather, find ways and examples to praise them on their strengths.

Balancing serotonin levels with nutrition is central to managing the range of symptoms that occur along the eating disorders continuum. — Leslie E. Korn Ph.D., MPH, LMHC, ACS, NTP

Watch out for Triggers:

These could include talking about food, weight, eating, dieting and making judgmental comments about your or anyone else’s bodies. This doesn’t mean you have to avoid eating in front of them (actually this would make things worse). Just try not to have entire conversations centered around food.

Watch out for You:

Supporting a friend or loved one through bulimia can be a very taxing process. It is important to make sure you take the time to look after yourself as well. Keep up your own support networks and take time away for you to relax and recharge as you won’t be any help if you are also very stressed or anxious.

For further information on supporting a loved one through bulimia, please see the links below.


How to Find Help Treating an Eating Disorder

Inpatient and Outpatient Treatment Plans for Bulimia Nervosa


Bulimia nervosa, a grave eating disorder, is also regarded as a major mental illness affecting a wide swath of the populace, especially young women, and has a devastating effect on the patients. Since bulimics, like anorexics, have the tendency to mask the symptoms associated with the eating disorder as well as keep the mental issues they might be facing, under wraps, diagnosing the issue becomes difficult. The longer the bulimic conceals his or her eating disorder (along with the accompanying psychological issues termed as dual diagnosis disorder or co-morbidity), the more complicated will be the recuperation or healing plan.

Someone who is struggling with an eating disorder may attempt to eat “normally” in the presence of others, and then look for opportunities to be alone to find ways to binge or purge. — Lisa Ferentz LCSW-C, DAPA

A patient who reports his bulimia nervosa disorder, after several years of having lived with the issue, should be mentally prepared to go through a protracted treatment plan before he recovers sufficiently enough.  On the other hand, bulimics who are forthcoming about their eating disorderliness and seek timely treatment start responding positively to a therapeutic program within a few days after induction into the process. Bulimia patients can opt for any or both the treatment programs available at medical facilities or centers-inpatient treatment therapy and outpatient treatment therapy.

Outpatient Treatment Plan for Bulimics                                              

Outpatient treatment plan works best for individuals who’ve been recently diagnosed with bulimia nervosa. This mode of treatment is usually the first line of treatment for those with a mild form of the disorder. There are several benefits to registering for an outpatient treatment therapy including cost-effectiveness and the leeway to continue with a normal lifestyle.

Now, there are different kinds of outpatient treatment plans including but not limited to medication plan, dietary counseling, interpersonal psychotherapy, group psychotherapy, and behavioral/cognitive therapy. Patients undergoing outpatient treatment are not required to take admission in a medical facility but rather continue staying in their homes. Since they display symptoms that happen to be mild, they may not need to be kept under round the clock supervision.

Balancing serotonin levels with nutrition is central to managing the range of symptoms that occur along the eating disorders continuum. — Leslie E. Korn Ph.D., MPH, LMHC, ACS, NTP

The sort of outpatient treatment procedure that a bulimic individual needs to go for considerably depends on the extent of care required and the medical professionals who will be offering support. Usually, such a patient will have to consult a nutritionist, psychotherapist, and a psychiatrist at the least. The family, eating disorder support groups, general practitioner, social worker, and other caregivers function as supplementary resources.

Outpatient treatment is generally non-residential in nature as the patient carries on with his or her daily life while periodically reporting to a care center for interpersonal therapy and/or group therapy sessions. Broadly speaking, there are three distinct kinds of outpatient treatments for bulimics-day treatment or partial hospitalization, intensive treatment, and general treatment. In a partial hospitalization program, the patient is able to access group therapy sessions and is also offered highly nutritious meals 3-4 times in a day.

Intensive treatment plans last for 3-6 months where the patient needs to devote some hours spread over days in a week and is most suitable for those with encumbrances. An intensive treatment program incorporates group therapy, one-to-one therapy, nutritional counseling, and controlled meals. General treatment is a specialized form of intensive treatment where the assistance of medical specialists like a naturopath, chiropractor or acupuncturist is sought.

The lack of seriousness taken by many patients regarding the medical sequeale of Anorexia and Bulimia, contributes to the inability to choose the best protocol for care and therefore increases the likelihood of treatment failure. — Judy Scheel Ph.D., L.C.S.W., CEDS  

Inpatient Treatment Plan

Inpatient treatment is recommended for bulimics who’ve had the disorder for many years and are completely unable to control their cravings for bingeing and purging. Keeping such patients under constant supervision in a medical facility will go a long way in coping with the chemical imbalances that result from excessive use of laxatives, emetics or diuretics. Supervised dietary and medicinal plans help in mitigating the chemical imbalances.

The temptations that trigger bingeing or purging are not available in a medical center.


Regardless of whether someone suffers from a mild or a grave form of bulimia, the fact that the person has to seek a treatment plan is inescapable. Additionally, the bulimia patient needs to be extremely patient in persevering with the treatment plan as it might take years before he or she can recover fully.

Some Surprising And Alarming Statistics About Bulimia



The lack of seriousness taken by many patients regarding the medical sequeale of Anorexia and Bulimia, contributes to the inability to choose the best protocol for care and therefore increases the likelihood of treatment failure. — Judy Scheel Ph.D., L.C.S.W., CEDS

Of all the different types of eating disorders that adversely affect people across all age spectrums, especially female teenagers and young adults, bulimia nervosa is one of the most predominant. An individual is said to be suffering from bulimia if he or she has an obsessive compulsion for staying lean and wiry, but at the same time is unable to control bingeing and maintain a disciplined dietary plan. Though bulimia can affect people of both sexes, regardless of their socioeconomic status or ethnicity, it is majorly prevalent in young women in the age group of 15-35 years.

Statistically speaking, bulimia nervosa affects 1.5% females and 0.5% females in the US which implies that about 4.7 million women and 1.5 million men are in the throes of this eating disorder. Bulimia nervosa is an idiopathic eating disorder as the exact causative factors behind it are yet to be pinpointed. However, it is believed that bulimia can result from the interplay of temperamental, environmental, and genetic factors.

Startling Statistics about Bulimia Nervosa


Sadly, there is a lot of guilt and shame attached to these behaviors so they tend to be done in private. — Lisa Ferentz LCSW-C, DAPA

The following are some surprising and alarming statistics about bulimia:-

  • Bulimia, more often than not, stems from starting out with and sticking to a dietary program intended to enable the individual to lose weight and become more self-confident
  • According to the National Institute of Mental Health, about 2%-4.2% females are inconvenienced by the eating disorder at some stage of their life
  • An individual is most likely to be diagnosed with bulimia when he or she is 20 years old
  • Bulimia is most prevalent in individuals aged between 18 and 59 years
  • About 0.6% of the adult populace in North America is affected by bulimia nervosa
  • Women showing symptoms of bulimia are more likely to report for drug abuse compared to females suffering from anorexia nervosa
  • There is a widespread misconception that bulimia causes an individual to lose excess weight. But in reality, some bulimics happen to be obese or overweight while others tend to have a normal weight
  • A professional treatment program to help an individual exercise control over his or her bingeing habit as well as assist in shedding the fixation to stay really thin lasts for a maximum of 6 months. The bulimic is kept under direct supervision in a medically assisted and controlled environment.
  • Approximately 10% of the American population troubled by bulimia are likely to seek treatment
  • About 80% of American women who have undergone treatment for bulimia have been discharged or released from the facility earlier than then they should have been
  • Recent studies and surveys have found that bulimic women are more vulnerable to getting addicted to marijuana, cannabis, heroin, tranquilizers, and alcohol
  • An individual is more likely to respond better to a treatment program or therapy in a care center in comparison to family or home-based treatment
  • Medical insurance schemes offered by insurance companies are very unlikely to offer coverage for bulimia treatment
  • 8% of bulimics show a high preponderance for bingeing without the urge to purge or vomit
  • A typical bulimic may consume over 2,000 calories at one go before having the urge to regurgitate
  • Racial minorities and youngsters in the age group of 8-12 are presently at a high risk of getting diagnosed with bulimia
  • An individual is most likely to develop bulimia nervosa because of a genetic predisposition, to the extent of 50%-80%
  • About 3.9% of bulimics are likely to die as a result of the eating disorder
  • 50% of anorexics have a high probability of developing symptoms of bulimia

Balancing serotonin levels with nutrition is central to managing the range of symptoms that occur along the eating disorders continuum. — Leslie E. Korn Ph.D., MPH, LMHC, ACS, NTP



Bulimia nervosa, despite being a grave eating disorder, is rarely fatalistic, and almost everybody suffering from the psychological condition can expect a full and speedy remission. However, one needs to be committed and extremely patient, as it takes many months or even several years to recover completely from the affliction.


Talking About Bulimia




Bulimia is a severe mental health disorder and one that is associated with a number of serious medical concerns. Supporting a loved one with bulimia can be a very challenging task. Your support may well be one of the things that helps them finally tackle this horrible eating disorder. Often it can be hard to know what to say and when to say it and with such a controversial subject, you may be concerned about saying the wrong thing, making it worse or even pushing them away. Below are some tips on how to speak with someone about bulimia at different stages of their recovery process.

The behaviors might get downplayed or even flat out denied by the person who is trying to sustain them. — Lisa Ferentz LCSW-C, DAPA

The First Conversation:

Talking with a loved one about bulimia can be extremely difficult. Not only is this a very controversial and often ‘touchy’ subject, due to the feelings your loved one is likely experiencing (such as shame or embarrassment), it is hard to approach this subject without them becoming defensive or very upset. Below are a few do’s and don’ts to help you engage in a productive conversation without pushing your loved one away.


  • Speak in a non-judgmental and caring way.
  • Use “I” statements to communicate this. For example, “I noticed……. and I am worried about you.
  • Give them time and space to communicate how they are feeling. This is not something that will be fixed with one conversation. It is also important to understand the feelings that are underneath the eating disorder, so giving them this time and space is very helpful.
  • Encourage them to seek help and let them know you will be there to support them in any way they need.
  • Be direct and honest, but in a caring way.

Balancing serotonin levels with nutrition is central to managing the range of symptoms that occur along the eating disorders continuum. — Leslie E. Korn Ph.D., MPH, LMHC, ACS, NTP


  • Avoid language that places blame or suggests that you are criticizing them or their behavior.
  • Try not to be a therapist and remember it is okay for you not to have the answer to everything. It’s more about letting them know you are concerned and offering them a chance to discuss their feelings.
  • Don’t focus the conversation on food and instead keep it centered on their feelings.
  • Never try and threaten them or manipulate them. This will likely only increase their anxiety and make it worse (as well as making them less likely to approach you in the future for support).


What if they deny it?



For people suffering from bulimia, it has often become their way of coping. So denying that their eating disorder is a problem, or that they even have one is a way that they protect themselves. As tackling the eating disorder will require taking a coping strategy away from them, you need to continue to offer them lots of love and support. Be non-judgmental in your approach and let them know you will be there every step of the way if required.

 In order to understand how to treat, understanding what we are treating makes sense. — Judy Scheel Ph.D., L.C.S.W., CEDS

While They are Going through Treatment:




  • Praise – Let them know that you have noticed they are making changes. Tell them you know how difficult it is for them and that you are really proud of how they are going.
  • Separate – Separate them from the eating disorder. Often they can feel as though they are one and the same, and reminding them that this is not the case is very helpful. Separating the two helps them to see that there is a possible future where they can exist without the bulimia.
  • Tell them to rest – Let them know that it is okay to take a break. Tackling the bulimia is likely to take a significant emotional toll on them and this takes a lot of energy. They may feel the need to continue with their normal goals and tasks, but sometimes they may just need a little break. Let them know that this is okay, and sometimes it is necessary.
  • Be normal ­- Invite them to do tasks you used to do together and try not to focus on the bulimia or food every time you see them. This will again remind them that they are not the disorder.
  • Compliment – Give them compliments to boost their confidence. Don’t focus these on their body or weight. Try and ideally choose personality traits that you can praise. If this doesn’t work, focus on other aspects of appearance such as their hair, color of their nail polish or even their new bag.

For further guidance on talking about bulimia or talking to someone who is fighting bulimia, please see the links below.


How A Mother Must Act When She Realizes That Her Daughter Has Bulimia



People who are purging tend to go to the bathroom immediately after eating, and use breath mints and bathroom spray to cover the odor of vomit. They get scarring on the finger they bite down on to do self-imposed vomiting and tend to develop dental problems as well. — Lisa Ferentz LCSW-C, DAPA

I didn’t know what to do back then. It was like I was in a state of shock with what I witnessed. I came inside my daughter’s room and there, I noticed that it reeked of puke. The room smelled of rotten food and vomit combined. It was the worst. No wonder she didn’t want me inside it every time I would ask to go in.

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Bulimia Nervosa – Binge-Purge Cycle And How To Stop It



Bulimia nervosa afflicts approximately 4% of women and 0.5% of men in the US. Nearly 4% of those suffering from bulimia will die from the disease and nearly all struggling with the illness experience serious medical and/ or emotional effects. — Alexis Conason Psy.D.

Physical appearance has been a significant issue in this society where we live in – if you’re not that beautiful, the world can be cruel and unfair. In today’s modern society, this is so very true. And with that, people who are suffering from bulimia are the usual victims of this “slim is beautiful” stigma. If you are not slim, you are not IN. You won’t matter in this world where competition for beauty is given such importance by many.

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The Effects Of Bulimia Nervosa In Teens – Therapists Are Worried For The Girls


In a world where there are beauty standards, a lot of teens are pressured into thinking on that’s how they are supposed to look, act, and portray themselves. The beauty industry has set an impossible situation for teens and young adults that results in both physical and mental health problems. This leave therapists worried about these girls and you should too. In this article, we will be talking about the effects of bulimia nervosa to teens and why this illness is on the rise.

Bulimia nervosa afflicts approximately 4% of women and 0.5% of men in the US. Nearly 4% of those suffering from bulimia will die from the disease and nearly all struggling with the illness experience serious medical and/ or emotional effects. — Alexis Conason Psy.D.

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How I Recovered From My Bulimic Nightmare With The Help Of Total Gym XLS

Setting an appointment with a psychologist was my decision after years of bingeing on unhealthy foods – a habit that I kept from my family since I was a teenager. I did not know what kind of eating disorder I had at the time, but I was sure at the back of my mind that it was something serious. And if I wanted to get out of that nightmare, I had to face the truths that: 1) I needed help, and 2) I could not heal without others’ support.

Denying the problem and thereby denying its effects are not uncommon. Patients sometimes lie also about the severity of their condition, further hampering the selection of appropriate treatment options. — Judy Scheel Ph.D., L.C.S.W., CEDS

When the diagnosis came, and my psychologist revealed that I was dealing with bulimia nervosa, I was no longer surprised. Since I already found out the name of my enemy, my focus turned to various ways that could help me to detach myself from the disorder.

I have tried a lot of therapies and techniques ever since, but what has genuinely allowed me to love myself better and feel more empowered is the Total Gym XLS that my parents gifted to me several years back.



What Is Total Gym XLS?

The Total Gym XLS is known as the universal home gym for total body workout. The key benefit of getting this product is that you will no longer be required to attend gym classes and pay thousands of dollars annually for membership. There are exercise charts, diet plans, and workout videos that come with the equipment, that’s why you can do this by yourself. The age range and weight capacity that Total Gym XLS can handle are so diverse that whether you reach your 60s or go over 300 lbs., it can still be of service to you.

Its creator must have wanted it to become a full-body workout device because handy accessories are within the box. In case the consumer aims to have abs, lose belly fat, bulk up his or her biceps and triceps or tone the lower portion of the body, you will see an appropriate attachment that can assist you in making any of these happen.


Gliding Board – The consumers can tone any part of their body even if they stay on the board, considering it slides effortlessly on the two poles that are connected to the mainframe. It ensures that the individual will be able to execute different exercises more efficiently.

Padded Board – User’s comfortability remains to be of importance for the manufacturer since they have made sure that the board is well-padded. A workout is hard on its own; that’s why the padding should not make their body ache.

Pulley – This device has several gym accessories included in the package that works when you pull the accessories. Hence, the improvements done on its pulley system will smoothen the training.

Squat Stand – Having the right form is essential when you do squats to achieve a better outcome. Some people, however, take a while before they get the hang of it. For that reason, it is a good thing that they can make use of the squat stand that is attached to the equipment. With this, they can practically lie flat on the board and glide with it.



Wing Accessory – If you like to build muscles on your upper body, the wing accessory is going to be useful to you. It can also be utilized while you are on the board.

Leg Pull Attachment – Such an add-on can strengthen all the muscles on the thighs and legs. It is beneficial for runners and other athletes who want to train at home as well.

Symptoms of depression including sleep disturbance, excessive guilt, feelings of helplessness or hopelessness and loss of interest in activities that used to be pleasurable, can be the byproduct of feeling trapped or stuck in a behavior that they know on some level is harmful to them. — Lisa Ferentz LCSW-C, DAPA

Other Reviews I’ve Seen

One of the men in our neighborhood has the same equipment, and he likes how the attachments and the gliding board seem to make their movements more fluid, as well as the fact that it necessitates them to use their weight to make it function. For this guy, the lack of automation makes it extra helpful for those who wish to lose body fats.

Another person has mentioned that the equipment does not need vast floor space, unlike the typical gym devices. It folds up nicely too; that’s why you can place it against a wall or in the storage room after every use

According to a veteran soldier who has bought it as well, the Total Gym XLS has allowed him to exercise again without putting much tension on his injured body parts. The cushioned board is a great addition too since his backaches have been reduced.



Why The Universal Home Gym Equipment Might Save You As Well

The Total Gym XLS is not advertised as a tool that treats or combats psychological disorders, but it has become a great help during my recovery period. After all, the equipment has allowed me to gain a little muscle and feel confident about my body again without needing to exercise outside. It comes with most of the devices that can be found in the gym, so there has been no pressure to come out and mingle with people until I felt ready.

Bulimia nervosa afflicts approximately 4% of women and 0.5% of men in the US. Nearly 4% of those suffering from bulimia will die from the disease and nearly all struggling with the illness experience serious medical and/ or emotional effects. — Alexis Conason Psy.D.

Although I’m not saying that you should stop your treatments or avoid your psychiatrist or psychologist now, it won’t hurt to use a similar home gym equipment to strengthen your body and mind. Good luck!