1st line treatment of - sampangi04

[ArchivalUser]

bulemia?
treatment and the order in which u treat ?
anyone?
thanx

[ArchivalUser]

first u take care of pt thru family and individual therapy,,,,,,,,hospitalization is of no help here.......
understand the psychology behind the problem and then approach it with pharmacotherapy or behavioral therapy

[ArchivalUser]

Tx: 1st hospitalize for ECG (hypokalemia-induced arrhythmia is MCCOD), electrolytes, amylase, LFTs, esophageal/gastric rupture, suicide risk.
2nd psychotherapy, nutritional counseling, SSRI for binging

[ArchivalUser]

Treatment

When you have bulimia, you may need several types of treatment, although combining psychotherapy with antidepressants may be the most effective for overcoming the disorder. Treatment is generally done using a team approach that includes your primary care doctor or other medical provider, mental health providers, and dietitians, all with experience in eating disorders. You may have a case manager to coordinate all of your care.

Try to be an active participant in your bulimia treatment. Working together, you and your doctor or therapist can decide which treatment options may be best for your situation, depending on your symptoms and their severity, your personal preferences, insurance coverage, affordability, treatment side effects and other factors. If your bulimia is very severe, a doctor, loved one or guardian may need to guide your care until you're well enough to participate in decision making.

Here's a look at bulimia treatment options and considerations:

Medical care
If your bulimia has caused health complications, such anemia, those must be treated. You also may need frequent monitoring of your vital signs, hydration level and electrolytes to ensure your condition isn't getting worse. If your complications are serious, you may need to be hospitalized until your health is stabilized.

Psychotherapy
Psychotherapy is a general term for a way of treating bulimia by talking about your condition and related issues with a mental health provider. Psychotherapy is also known as therapy, talk therapy, counseling or psychosocial therapy.

Some studies show that a type of talk therapy called cognitive behavioral therapy offers the most benefit in treating bulimia. Cognitive behavioral therapy helps you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones. This type of therapy is based on the idea that your own thoughts ” not other people or situations ” determine how you behave.

Interpersonal therapy also may be effective for treating bulimia. Interpersonal therapy focuses on your current relationships with other people. The goal is to improve your interpersonal skills ” how you relate to others, including family, friends and colleagues. You learn how to evaluate the way you interact with others and develop strategies for dealing with relationship and communication problems.

Medications
Antidepressant medications may help some people with bulimia. The only antidepressant specifically approved by the Food and Drug Administration to treat bulimia is fluoxetine (Prozac), a type of selective serotonin reuptake inhibitor (SSRI). However, doctors can also prescribe other antidepressants or medications to treat your bulimia. Some research suggests that antidepressants may reduce the frequency of bingeing and purging. Antidepressants or psychiatric medications can also help treat accompanying mental disorders, such as depression or anxiety.

Nutritional therapy
In some cases, you may have a dietitian on your health care team. A dietitian ” or another medical provider ” can teach you about eating a healthy diet and meeting all your nutritional needs. A dietitian can also design a customized eating plan to help you achieve your weight and nutrition goals.

Hospitalization
Bulimia can usually be treated outside of the hospital. But if you have a severe form of bulimia and serious health complications, you may need treatment in a hospital. When needed, hospitalization may be on a medical or psychiatric ward. Specialized eating disorder clinics offer intensive treatment, usually for several weeks or months. Other clinics or eating disorder programs may offer day treatment, rather than full inpatient hospitalization. Check with your health insurance provider to see what kind of coverage you have for eating disorder treatment. If you lack insurance coverage for the intensive treatment you need, work with your doctors and mental health providers to find solutions.

Treatment challenges in bulimia
Like other eating disorders, bulimia can be difficult to overcome or manage. Although the majority of people with bulimia do recover, some find that bulimia symptoms don't go away entirely. Bulimia may be more like a chronic condition that requires long-term care. Periods of bingeing and purging may come and go through the years, depending on your life circumstances. In times of high stress, for instance, you may return to familiar, if unhealthy, eating behavior. If you find yourself back in the binge-purge cycle, "booster" sessions with your health care providers can help you weather the crisis before your eating disorder spirals out of control again. Learning positive ways to cope, creating healthy relationships and managing stress can help prevent a relapse.

[ArchivalUser]

this is as per mayo clinic guidelines,
my point here is stefan, that bulimia can be treated as an outpt,,,,,,,,,hospitalization is not the first step here, yes it is needed if severe bulimia with impending damage from electrolyte deficiency

[ArchivalUser]

stefan ---is the protocaol same for anorexic----becoz ur answer s for anorexic

[ArchivalUser]

egjactly, thats what i am talking about here,,,,,,,,,,hospitalization is first for anorexia, with menstrual problems and with severe wt loss of more than 15%...............not the same protocol for bulimia/////////////////its easy but confusing

[ArchivalUser]

thanx

[ArchivalUser]

okie dokie