Treating Bulimia Assignment Essay

Bulimia is a psychological and severe life-threatening eating disorder. It can affect anyone of any age, gender, or background, however, studies have argued that it is strikingly common among younger women. This disorder is characterized by repeated episodes of binge-eating food in a short period of time, due to a lack of personal control. Consequently, since bulimic people give an excessive importance on their body shape or weight, they make themselves vomit as a compensatory behaviour.Treating Bulimia Assignment Essay The two main treatments proposed by NHS are cognitive behavioral therapy for people over 18 years old and family therapy for bulimic people who are underage (“Bulimia”, 2017). This essay will in fact analysis, with a critical perspective, the effectiveness of CBT in treating bulimia nervosa. Firstly, the causes and symptoms of BN will be described, subsequently, CBT for BN will be critically evaluated. The evidenced of the presented studies will suggest that despite CBT is not able to treat all the patients, it still has a high efficacy and thus it is the clear leading treatment for bulimia nervosa.

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Eating disorders are life-threatening illnesses that unfortunately seem to affect between five to ten million adolescent girls in the United States (National Eating Disorders Association, 2006). More specifically, 1-4% of American college women are diagnosed with bulimia nervosa (American Psychiatric Association [APA], 2013). People with this eating disorder experience a lack of control when exposed to food. During an episode of binge eating, people eat, within a two-hour period of time, more food than a person with the same height and weight would, in similar circumstances (APA, 2013). Bulimic people claim that while they binge eat they lose control over the quantity and the quality of food eaten, and they feel like they cannot stop themselves from eating.Treating Bulimia Assignment Essay Therefore, in order to compensate this behaviour, they engage in self-induced vomiting, excessive exercise, and they take laxatives, diuretics and diet pills.This unhealthy behaviour is the cause of several negative physical problems. For instance, bulimic people have a constant feeling of weakness and tiredness due to problems in their muscles and bones. Moreover, possible complications of bulimia include dental problems, caused by the stomach acid, dry skin and hair, swollen glands, fits and muscle spasm. Heart, kidney or bowel problems, including permanent constipation, along with bone problems such as osteoporosis, are other effects of bulimia. Considering these health risks, why would people decide to adopt such a destructive behaviour? Although on the surface, it appears that the main concern of bulimic people is their physical aspect, this worry is simply a symptom, a consequence, of more profound and serious issues. Several can be the causes behind the development of bulimia nervosa. It can be triggered by a genetic component, the social context, the personality of the person or a traumatic event (“Bulimia”, 2017). By analyzing the family history of the patients, it seems that quite often members of the family have experienced episodes of depression, alcohol/drug addiction or eating disorders (the genetic component is between 30% -80%). The social context does seem to play a role as well, for instance, some of them might pressure people to be extremely slim (e.g. ballet dancers or models). Moreover, BN could also be caused by several critiques that have been made on the patient regarding her/his eating habits, body shape and weight. When it comes to personality traits instead, bulimic people usually have similar characteristics. For instance, they suffer from anxiety, they have a low-self-esteem, an obsessive personality, they are perfectionists, and want to be in control of every external situation. Lastly, people might engage in this destructive behaviour as a consequence of a traumatic event occurred to them in the past.Treating Bulimia Assignment Essay For instance, some people who have been sexually abused developed bulimia nervosa.

Throughout the years, doctors, psychotherapists and psychiatrists have worked in order to create efficient methods to treat this disorder. Fortunately, people can recover from bulimia nervosa and its main treatments are interpersonal therapy (IPT), family therapy, medication, and cognitive behavioural therapy (CBT). Interpersonal therapy does not focus on reducing the bulimic symptoms, instead, it aims at identifying and work on the interpersonal problem(s) of the patients that appears to be related to the development of their eating disorder. This therapy is helpful for people who do not want clear behavioural directives, but they are looking for a treatment with some structure, focus and containment (Apple, 1999). IPT usually results in changes across all areas of symptoms, the only issue is that, compared to CBT, it takes longer to achieve its effects (Fairburn, 1993). The family therapy treatment (20 weeks long) is often offered to children and adolescents. In this intervention, doctors meet the family members along with the patient and provide them with practical strategies to overcome this eating disorder. There has been a number of positive response to this type of therapy, but mainly in adolescents with a relatively short history of bulimia nervosa (Stewart, Voulgari, Eisler, Hunt & Simic, 2015). Since people with BN also tend to have anxiety, depression, social phobia or obsessive-compulsive disorder, the therapists might decide to provide to the patients, in combination with a psychotherapy treatment, antidepressants such as fluoxetine (Prozac). This essay, however, will focus on the last treatment method previously listed: cognitive behavioral therapy.

CBT is one of the most widely recognized treatments used in several clinical domains. In the case of bulimia nervosa, CBT is chosen when patient age does not mandate family therapy and when their symptoms are moderate to severe.Treating Bulimia Assignment Essay Despite CBT recognizes that this disorder is also caused by biological factions, its model bases the intervention on the assumption that BN develops due to cognitive disturbances and behavioral disturbances. The former ones cause people to be overly concern about their eating habits and the shape/weight of their bodies while the latter ones affect the persons’ eating controlling behaviour. As bulimic people internalize these beliefs they develop a dysfunctional schema. This cognitive schema is express through the patients’ external behaviour, as they become extremely focused on their body and they aim to obtain unrealistic levels of thinness and control (Wilson, Fairburn, Agras, Walsh & Kraemer, 2002). Studies have shown that CBT is the intervention with the most evidence-based positive outcomes (e.g., Craske, 2010). This therapy is well-structured, has a time-limit, it is focused on the present, and it is directive which means that the clinician actively offers advice and information to the patient instead of just basing the therapy sessions only on the information supplied by the client. These stylistic features seem to be perfect for bulimic people as they usually experience lack of control in terms of their eating and in other areas of their life, therefore CBT helps them to find a safe, containing structure where they can work on changing their maladaptive behaviors.

Cognitive behaviour therapy program for Bulimia Nervosa involves approximately 20 sessions (one session per week) (Fairburn, Marcus, & Wilson, 1993). These sessions are divided into three phases. In the first one, bulimic patients learn the negative physical and psychological problems caused by binge eating, purging and extreme dieting.Treating Bulimia Assignment Essay Along with this psycho education, the therapists teach patients to establish a regular pattern of eating and to learn how and when to monitor their own weight. In the second phase, patients learn how to adjust the cognitive distortions and behavioral dysfunctions related to eating habits and weight. By doing so the patients reduce their concerns regarding their body and the dieting behaviour. Moreover, in this phase, the therapist uses a schema-based approach that analyses and modifies other problems that affect the psychological well-being of the patients. The last phase of the cognitive behavioral therapy for bulimia nervosa focus on maintaining the learnt healthy behaviors and prevent future episodes of binge eating and purging. At the end of the last session, participants are provided with a personalized program me that will help them to prevent the chances of relapse. CBT is usually administrated individually, however, therapists can decide to conduct a group-intervention. Despite these phases are presented in a sequence in the manual, in reality, it is up to the clinician to decide the series of the phases, based on the personality of the patient and the severity of the symptoms. For instance, if at a certain point during the therapy treatment the patient returns to frequently binge eating and purging, then the clinician will shift the focus of the therapy session back to the first or second phase.Treating Bulimia Assignment Essay

 

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