Treatment of Bulimia Nervosa

Learn about bulimia treatment, symptoms, causes, and our unique approach to working with eating disorders at Opal.

What is Bulimia Nervosa?

  • A mental health condition with complex origins 
  • Repeated binge episodes, which means consuming a very large amount of food and feeling out of control.
  • Repeated “compensatory behaviors” to prevent weight gain such as self-induced vomiting, misuse of laxatives, fasting/restriction, or excessive exercising
  • The compensatory behaviors often will give a sense of relief and/or control.
  • Shame and guilt are often a part of the bulimic cycle. 
  • A fixation on one’s body weight/shape and attributing this to self-worth

What are the signs and symptoms?

Although one could struggle with many of the above signs and symptoms of bulimia nervosa, it can be sometimes difficult to identify when you or someone you love is struggling. A change in one’s patterns, attitudes, beliefs, and behaviors with food, weight and exercise could be a sign of something more serious going on.  Due to so many culturally normative values around weight and health, bulimia can be difficult to detect.  We encourage having a professional that specializes in eating disorders help you or your loved one get clarity on what is really going on. If you would like to get more information on supporting a loved one, see our advice

Things you might not know about Bulimia.

  • You cannot tell someone is struggling with bulimia by looking at them. Body weight may or may not change due to the eating disorder. 
  • Someone who is exercising excessively might be experiencing exercise bulimia, meaning they are trying to compensate for food intake with exercise.
  • Someone struggling with bulimia nervosa could be temperamentally inhibited or uninhibited.
  • Some people’s cycle of bulimic behavior could be a cycle involving bingeing and  restriction, which is different from binge eating disorder. 

Check your biases! 

Bulimia Nervosa can be life-threatening for anyone that is experiencing it, regardless of body size, race, ethnicity, socio-economic status, gender, sexual orientation, age, ability, religion. 

Opal's Approach to the Treatment of Bulimia

The treatment of Bulimia is individualized. We take a holistic approach to treatment that allows for healing to be done in community and in individual sessions. We believe eating disorders develop to serve a function for an individual.  Opal’s staff come alongside our clients to better understand those “whys” and find new ways to cope and live life without an eating disorder.  We offer three levels of care at our Seattle clinic. Overall, our treatment model includes: 

  • Individual therapy, nutrition counseling, psychiatry, exercise experientials and family/relationship therapy available at the PHP and IOP levels of care. 
  • Health at Every Size, weight-neutral treatment approach 
  • Non-diet approach to food. Meals and snacks provided offer a wide variety of foods (highly processed, fresh, organic, non-organic, home-cooked, frozen, easy to prepare, etc.) 
  • Eating at meals and snacks are done with other clients and staff, as a community.
  • A belief that adequate food intake is a foundational step in recovery. 
  • Exercise + Sport programming, which addresses exercise bulimia, exercise avoidance, and other exercise concerns
  • Radically Open Dialectical Behavioral Therapy as a foundational treatment 
  • Group therapy including body wisdom group, movement group, self-inquiry, process groups, facing fears and more. 
  • Teaching/Didactic groups including Radically Open Dialectical Therapy, Acceptance and Commitment Therapy, Exercise + Sport Didactic, Health at Every Size Didactic, etc.
  • Non-clinical lodging for PHP clients to use while in treatment, available for a weekly fee and as space allows. 
  • Alumni outpatient groups