Some alternative medicine interventions could be helpful to reduce the signs and symptoms of bulimia nervosa (Mayo Clinic, 2018d; WebMD, 2017a): ● Mind–body therapies: These include meditation, yoga, and biofeedback. Such interventions are designed to facilitate relaxation, reduce stress, and increase a sense of well-being. ● Acupuncture: Acupuncture may help to alleviate anxiety and depression. Research is being conducted to determine its effectiveness. ● Drug rehabilitation: If clients are also abusing alcohol or other drugs, they may need to participate in a drug rehabilitation program. Self-help and support groups could also be of benefit. ● Nutrition: It is most likely helpful to reduce or eliminate alcohol, caffeine, salt, flavor enhancers, and cigarettes. Some healthcare providers recommend vitamin C and B complex supplements. Healthcare Interventions It is important to provide healthcare interventions that are necessary for improvements in client care and enhancing client outcomes, as well as to add to the body of knowledge that is nursing. The behaviors associated with bulimia nervosa can trigger feelings of revulsion in the general public and even in healthcare professionals. Trying to understand how someone can deliberately force themselves to vomit, abuse laxatives, abuse diuretics, and even give themselves repeated enemas in an effort to prevent weight gain is incomprehensible for some nurses and other members of the healthcare team. They may think, “If she wouldn’t eat all that food in one sitting, she wouldn’t need to make herself vomit.” Part of health care practice should be to act to change the prejudice associated with bulimia and other eating disorders. Part of this prejudice could be an unconscious belief that the eating disorder is self-inflicted and self-induced. It is as if the disorder is somehow the fault of the person who is suffering from the disease. This attitude is similar to the attitude that lung cancer is somehow the fault of the patient who smokes, or that heart disease is the fault of the person who eats foods high in fat and cholesterol. Such conscious or unconscious beliefs can adversely affect the delivery of client care (Gersch et al., 2016; Mayo Clinic, 2018d; Videbeck, 2017). Here are some suggestions for nurses as they attempt to improve healthcare and client outcomes in the population suffering from bulimia nervosa (Gersch, Heimgartner, Rebar, & Willis, 2016; Mayo Clinic, 2018d; Videbeck, 2017). Healthcare professionals should honestly assess their own feelings regarding bulimia nervosa and other eating disorders. They should ask themselves if they have any personal animosity or feelings of revulsion toward persons with the disease. Can they remain objective? Do they allow feelings of disgust or amusement to influence how they provide care? What can they do to increase their understanding of eating disorders and provide better care? If family dynamics are poor or if there is a history of abuse, can they objectively support family therapy? If their personal beliefs and values are found to have a negative impact on client care, what can they do to change these negative attitudes? Healthcare professionals should seek continuing education opportunities regarding bulimia nervosa and other eating disorders. What kinds of educational opportunities exist at work? Can they suggest that these topics be incorporated into the professional development courses provided by the organizations for which they work? If bulimia nervosa and other eating disorders are not part of the organization’s continuing education
Healthcare consideration : Most people with bulimia nervosa recover, but some find that symptoms do not go away permanently. Episodes of binging and purging can recur throughout the person’s lifetime, particularly during periods of stress or anxiety (Mayo Clinic, 2018d; Videbeck, 2017). Clients and families must be educated about the possibility of recurrence and instructed to seek immediate medical help if this occurs. The effectiveness of treatment varies according to the ability of the client to recognize what triggers binging and purging and their ability to deal with these issues. Some people recover completely; others relapse. It is important that healthcare professionals realize that some people with bulimia nervosa need lifelong monitoring (Gersch et al., 2016; Videbeck, 2017). Moreover, it is important that persons affected by bulimia nervosa and other eating disorders receive objective supportive care. Healthcare professionals must not show disgust or amusement, nor should they behave in a judgmental fashion. Objectivity and empathy must be part of the healthcare professional’s demeanor (Gersch et al., 2016; Videbeck, 2017). courses, where can they go to obtain such education? Have they investigated online resources? Have they reviewed the websites of reputable organizations—such as Mayo Clinic, CDC, American Psychiatric Association—for more information regarding eating disorders? Healthcare professionals should be able to differentiate between anorexia nervosa, bulimia nervosa, and other mental health disorders. Some nurses and others are not aware of the distinguishing characteristics between the various eating disorders, nor are they aware that anorexia nervosa and bulimia nervosa can coexist. All healthcare professionals should be aware of the diagnostic criteria for each of the eating disorders. Healthcare professionals should institute client/family education regarding eating disorders. Such education should not take place exclusively in inpatient and outpatient settings. Social workers in community settings, school social workers, college campus social workers, and those who work with sports injuries all have excellent opportunities to educate colleagues as well as young women and men and their families and friends. Recognition of eating disorders is important. But it is perhaps more important for at-risk groups to recognize their vulnerability and how to deal with stress and anxiety in healthy ways rather than inappropriate, even dangerous, behaviors. Healthcare professionals must promote health and wellness by assuming the role of leader and client/family advocate. Healthcare leaders must battle the view of the ideal woman’s body as portrayed on television, in movies, in print media, and on social media. This image is usually an airbrushed version of an extremely, unrealistically thin woman. Persons with eating disorders are often given verbal rewards when family and friends make such comments as, “I wish I were as thin as you,” “You look fantastic,” or “Since you lost weight, your basketball game has really improved.” These kinds of positive reinforcements may make people who suffer from bulimia nervosa and other eating disorders question if they are really ill, and they ask themselves, “How can I be sick if everyone tells me how great I look?” This can be especially true for those dealing with bulimia nervosa because they are usually of normal or slightly above normal weight and may not have the health issues associated with the near-starvation states of those who have anorexia nervosa (Gersch et al., 2016; Mayo Clinic, 2018d; Videbeck, 2017). Healthcare professionals can help to dispel myths surrounding bulimia nervosa and other eating disorders by taking the following actions (Gersch et al., 2016; Mayo Clinic, 2018d; Videbeck, 2017): ● Promoting the identification of relevant research questions that pertain to bulimia nervosa and other eating disorders.
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