Intervention to Help Someone with Bulimia Nervosa - How to Help Someone with Bulimia Nervosa

Written by Judith Asner

The Intervention Continues

When we left Mary, she was sitting on a sofa in Lisa's living room, surrounded by friends and family members who cared enough about her to stage an intervention. By ten o'clock, everyone had spoken, and looked completely exhausted.

Yet there was one more very important subject to discuss - getting Mary help. Mary's parents and Dr. Gilbert, a friend of the family, sat down next to Mary, who was still sniffling. Julia reached for Mary's hand and held it tight.

"Mary," Dr. Gilbert began, "we've all been doing some research on how to get you the best help possible. There's a wonderful residential treatment center that specializes in women's issues, especially eating disorders."

"You mean a hospital?" Mary said, dabbing her eyes. "I don't need a hospital."

"Let Dr. Gilbert finish," Richard said firmly.

"It doesn't really look like a hospital, Mary. It's a beautiful old estate, and it sounds like a good place for you. There are psychiatrists, social workers, and nutritionists, all specially trained to help people with eating disorders, and it's all under one roof. They can help you overcome your fear of food by eating with you. After meals, they'll sit with you so you can talk about how you're feeling and help you get used to the sensation of having food in your stomach. In the morning, they'll help you realize that you wake up looking the same as when you went to sleep. Many of them had had bulimia themselves, so they know what it takes to recover from bulimia. They know how it feels."

"But they'll make me eat too much, more than I should. I'll get fat!" Mary said, her voice rising in panic.

"I understand that you're worried about that," Dr. Gilbert said, "but one of the things you'll relearn is that on a normal diet you can eat three meals a day without getting fat. When you eat until you're comfortable and stop, you don't have to purge. And if you do gain a pound or two, they'll help you work through it until you feel OK."

"What I like best about the idea," Julia said, "is that you'll be with other young women like yourself, so you won't have to feel so alone anymore. And Dad and I will visit you for family therapy sessions. We're all in this together."

Mary looked at her father. "Dad, this is going to cost you a fortune. I can't ask you to do this for me. I feel too guilty."

"We're doing it, Mary. Whatever we have to pay, we're paying. You're our daughter, and we're not letting anything happen to you. No way. We love you."

"That's right," Julia said. Mary couldn't remember the last time her parents had agreed about anything.

"But what about work?" Mary cried. "Everyone will know. It's so humiliating. Please give me a chance to do this on my own. I'll do therapy, twice a week if you want, even three times. Just let me try by myself."

Her parents looked skeptical, but Mary felt Dr. Gilbert's sympathetic eyes on her. Finally, Dr. Gilbert said, "OK, Mary, you're an adult, so we'll treat you as one. You deserve a chance to try it your way, at least for six months. I can give you the name of a psychiatrist who works with women with eating disorders. Let's start there."

And she handed Mary the name and number of Dr. Melody Fine.

Judith's comments

Like Mary, many women with bulimia beg for a trial of outpatient therapy for bulimia before entering an eating disorders treatment center. Often, with enough support, they can break the binge-purge cycle. It isn't easy, and it takes great determination - almost like having a second job.

Dr. Gilbert sensed that Mary's desire to get well on her own was genuine and arose from within her. She also knew that getting involved in a power struggle with Mary wouldn't help since issues of control are central to Mary's illness.

In the end, Dr. Gilbert decided to support Mary's autonomy. Julia had also tried to support Mary, but she did it by talking to Mary as if she were a little girl. Dr. Gilbert treated Mary as a capable adult.

Did You Know?

According to James E. Mitchell, MD, and his research group at the University of Minnesota Medical School:

• Bingeing usually begins after a period of restrictive dieting.
• Purging behaviors (excessive exercising, use of laxatives, or vomiting) begin approximately one year after binge eating begins.
• The average length of time women spend bingeing ranges from 15 minutes to 8 hours, with an average duration of 75 minutes.
• People with bulimia binge an average of 11.7 times each week.
• During binges, people with bulimia consume an average of 3,415 calories, the total number ranging from 1200 to 5000.

Judith Recommends:

"My Name is Caroline," by Caroline Adams Miller (Gurze Publishing). It can be ordered on-line at www.gurze.com.

This is the inspirational yet realistic story of a high-achieving Harvard College student who appeared to have it all - and who suffered in secret from bulimia for years. It chronicles her eventual victory over her eating disorder. According to Kirkus Reviews, this is "An important, affirmative book for overeaters who've lost hope of a cure."

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