The sooner an individual with bulimia nervosa is diagnosed and begins treatment, the better the outcome is likely to be. Due to its complexity, bulimia usually requires a comprehensive treatment plan including medical care and monitoring of health complications (e.g., irregular heart rhythms), psychological evaluation and dietary and/or substance abuse counseling. Medical treatment and management of bulimia is the same for both male and female patients.

In severe cases of dehydration, immediate hospitalization of the patient can be necessary to rehydrate (restore loss of water) and restore electrolyte imbalance through intravenous (into a vein [I.V.]) feeding. Emergency medical attention also can be required if severe complications of prolonged bulimia, such as rupturing of the esophagus or heart failure, occur.

Patients with dental problems (e.g., tooth and gum decay) resulting from chronic self-inducing vomiting may be referred to the care of a dentist (dental health specialist) for treatment.

Bulimia nervosa typically requires a multi-disciplinary approach for rehabilitation that may include:

• Nutritional counseling. Regular consultation with a nutritionist (licensed nutrition specialist) or registered dietitian is important for patients with bulimia. Nutrition experts may help patients understand the role of adequate nutrition for a healthy body, including the importance of a healthy, well-balanced diet. These specialists also conduct dietary counseling, which can help patients change the nature of their eating behavior. In the case of bulimia, a nutritionist may assist in establishing a pattern of regular, non-binge meals.
  
  
• Psychotherapy (e.g., cognitive behavioral therapy, family therapy). These types of mental health therapy will address and help treat psychological disturbances including negative body image, low self-esteem, substance abuse and interpersonal conflicts associated with bulimia as well as the causes that may have led to the development of the eating disorder.
  
  
• Drug therapy (psychotropic medications, such as antidepressants). Antidepressants, such as the selective serotonin reuptake inhibitors (SSRIs), have been found helpful in treating bulimia which co-exists with other types of emotional disorders, especially depression and anxiety disorders. Psychotropic medications may also help prevent relapse of the eating disorder.

The U.S. Food and Drug Administration (FDA) issued an advisory to healthcare providers to monitor children and adolescents treated with antidepressants for increased suicidal thinking and unusual behaviors.

Patients with bulimia are urged to have regular check-ups with their physician to monitor their overall health and treat any complications, such as bradycardia (reduced heartbeat). Sometimes residential care that involves the patient remaining in a facility that specializes in treating the eating disorder may be necessary, especially in the case of chronic relapses or when patients have not been able to reach a significant degree of medical and psychological stability from their initial treatment plan.