Running head: SELF-HELP PROGRMAS FOR BULIMIA NERVOSA

Self-help Programs for Bulimia Nervosa Allison Boyles Manchester University

SELF-HELP PROGRAMS FOR BULIMIA NERVOSA

Abstract There are many new online self-help programs for eating disorders that are appearing all over the world. Many people say that these online self-help programs are beneficial to the patients. Many of the studies suggest that online self-help programs did benefit many of the patients and it helped them to overcome their eating disorder. Many of the studies also suggested that people responded to the online self-help programs better than a traditional face-to-face treatment clinic. Many of the people in the studies found the online self-help programs to reduce the unhealthy lifestyles that many of these people with Bulimia have. One study also suggested that the structured online self-help programs showed more benefits than an unstructured online self-help program. Overall though, the online self-help programs benefited many people in these studies and it is a good alternative to traditional face-to-face therapy. Keywords: Benefit, online, self-help

SELF-HELP PROGRAMS FOR BULIMIA NERVOSA

Many new methods have been discovered as alternatives to traditional person-to-person interactions between the patients that struggle with bulimia and the doctors that treat these patients. There are now many internet based self-help programs that people with bulimia can participate in for help. The online self-help programs are not free programs but they are not as costly as a traditional rehabilitation clinic would be. Therapists have also reported great advantages to these programs like the ability to reach clinics that live in rural areas. Patients also think of this as an advantage, because they do not have to leave their house to go to a clinic. These online self-help programs are constructed on self-report surveys. Many people in these self-help programs stated great levels of motivation to overcome these eating disorders. Employers even offer these internet based self-help programs to their employees to help encourage a healthy lifestyle. (Bedrosian, Striegel-Moore, Wang, 2011) Some of these self-help programs also help to ensure that the patients do not relapse after the treatment has ended. (Gulec, Moessner, Mezei, Kohls, Try, & Bauer, 2011) Self-help programs for binge eating are increasing on the internet and all over the world. These self-help programs are beneficial and help patients to overcome eating disorders. (Bedrosian et al., 2011) Bulimia Nervous is an eating disorder that includes episodes of binge eating followed by vomiting episodes. People that struggle with bulimia struggle with weight loss and the urge to binge eat. (Smith & Segal, 2013) Bulimia Nervosa is normally found in females, not many men have been diagnosed with Bulimia. Almost eighty percent of people struggling with Bulimia are females. Many people that are diagnosed with Bulimia have problems with depression and changes in social adjustment. (Bulimia) There are many negative effects of Bulimia Nervosa including: weight gain, abdominal pain, broken blood vessels in the eyes, tooth deterioration, mouth wounds, loss of menstrual cycles, and a ruptured stomach or esophagus. People struggling

SELF-HELP PROGRAMS FOR BULIMIA NERVOSA

with Bulimia are more at risk for suicide or mental complications. Bulimia Nervosa is a very dangerous eating disorder and it is also potentially life-threatening. (Smith & Segal, 2013) If a person is struggling with Bulimia they are usually preoccupied with their weight and body shape. Many people with Bulimia also judge themselves very harshly because they do not like their self-image, because of this bulimia is very hard to overcome. Effective treatment can make a person with bulimia feel better about themselves, help to contribute to a healthier lifestyle and reverse serious complications that this person might have because of Bulimia. This is why it is so important for a person that is struggling with Bulimia to get treatment. (Mayo Clinic Staff, 2012) In this study by Fong Leung, Ma, and Russell, there were twelve female contributors from age seventeen to forty-seven. In this online self-help program, there was information about eating disorders and questions about eating habits. This program produced automatic feedback for these patients that were a part of these online self-help programs. This feedback included the patients depression and anxiety levels. This helped the patients to better view their problems and what they needed to change. . Patients in the study had an overall positive view of this self-help program. Many of these people said that they gained a better understanding and awareness of their eating disorders. This self-help program also gave these people an understanding on what might be compelling their eating disorder. The program benefited these patients by improving their will to change, and to push them to change their eating habits. Because of this self-help program, many of these patients decided to change their eating habits and some even received further profession help for their eating disorder. (Fong Leung et al., 2012) According to Carrard et al., during this study, the participants were required to keep a food diary showing what they ate and a record of the vomiting episodes. This study shows the efficiency of the online self-help programs for people with eating disorders. In this study, there

SELF-HELP PROGRAMS FOR BULIMIA NERVOSA

were sixty-two female participants that were found to have signs of bulimia nervosa. Many of these patients showed improvements throughout this online self-help program and many showed a decrease in the number of vomiting incidents. . It was also found that online self-help programs like this one had many advantages to it like the ability for a therapist to contact a patient through this online self-help program. It was found that during this study the online self-help programs were helping many of these women that participated in the study. This study shows that the selfhelp program that these people were going through helped them to decrease their self-destructive eating habits. It also shows that many of these participants were able to change their behavior and be able to control their eating disorder. People using the online self-help programs showed more improvement than the people using the traditional face-to-face treatment. (Carrard et al., 2009) In the study by Gulec et al., they use an online self-help program to conduct a study onr the benefits of online self-help programs. This online self-help program is called EDINA and it stands for Internet-based Aftercare for Patients with Eating Disorders. EDINA provides online information and treatments for eating disorders. Many participants in this study reported that it was helpful because they could get support from other people and they could also be active in their own health. Many of the people that participated in this study actually continued with the program after the four months of the study, because they found this program to be helpful to them. Many of the patients that used this online self-help program also showed great improvement through the program. Many of these participants said that they would recommend this program to a friend that had an eating disorder. Most of the participants who did not continue with the program, said that they would even come back to this program if they had any further problems with eating disorders. Many of these patients also liked that they could get what

SELF-HELP PROGRAMS FOR BULIMIA NERVOSA

they needed without traveling to a clinic. Most of the participants in this study were satisfied with the program and their symptoms seemed improve through EDINA. (Gulec et al., 2011) In the article Internet-Based Interventions for Eating Disorders in Adults: a Systematic Review, the authors examined peer-reviewed articles to find if online self-help programs help these people to overcome their eating disorders. All of the articles stated that the patients improved, meaning that their eating disorder decreased over time. These articles also suggested that a variety of different treatments help patients more than just an internet self-help program. Online self-help programs did show improvements in the patients as well, but using email support and email therapy is said to help patients improve further. These articles also suggest that guided self-help programs showed more improvements than unstructured self-help programs did. In conclusion, internet-based self-help programs are a good substitute for face-to-face treatments, and particularly structured online self-help programs. (Dlemeyer, Kersting, Tietjen, Wagner, 2013) Online self-help programs are becoming increasing popular all over the world, and many people feel as though these self-help programs are beneficial to people that struggle with eating disorders. In these studies, many people reported that they were improving throughout the course of these programs. Some showed decreases in vomiting episodes and unhealthy eating habits. Many people even reported that they had an increased will to change and live a healthier lifestyle. Patients said that there were many advantages to having an online self-help program instead of driving to visit a person every day. Many of these programs even had questionnaires that helped the patients to learn more about themselves and their depression or anxiety levels. This helped the patient to learn more about what they needed to change to improve them to make them mentally healthier. It also helped these patients to better understand what might be causing

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their eating disorder. Many patients in these self-help programs achieved a better understand what they need to improve on and how to treat their eating disorder. Overall many people seem to prefer the online self-help programs over normal face-to- face treatment. Many of the patients feel as though they improved through the online self-help programs and would recommend these online ways of treatment to people that are struggling with an eating disorder. One of the studies also suggests that a variety of different treatments benefits the patients more than just the selfhelp programs. The study also suggests that structured online self-help programs are proven to be more beneficial to the patients than unstructured self-help program. Many patients like these selfhelp programs because they could get extra support from other people in these online self-help programs. Many people in these studies showed great improvements in their eating disorders and they began to overcome them. All the studies in this paper have shown that these new online self-help programs benefited many people, and they are an excellent alternative to traditional face-to-face rehabilitation clinics.

SELF-HELP PROGRAMS FOR BULIMIA NERVOSA

References Bedrosian, R. C., Striegel-Moore, R. H., & Wang, C. (2011). Demographic and clinical characteristics of individuals utilizing an internet-based digital coaching program for recovering from binge eating. International Journal Of Eating Disorders, 44(7), 639-646 Bulimia Nervosa. NEDA feeding hope website. Available at: http://www.nationaleatingdisorders.org/bulimia-nervosa Carrard, I. I., Fernandez-Aranda, F. F., Lam, T. T., Nevonen, L. L., Liwowsky, I. I., Volkart, A. C., & ... Norring, C. C. (2011). Evaluation of a guided internet self-treatment programme for bulimia nervosa in several European countries. European Eating Disorders Review, 19(2), 138-149 Dlemeyer, R., Tietjen, A., Kersting, A., & Wagner, B. (2013). Internet-based interventions for eating disorders in adults: a systematic review. BMC Psychiatry, 13(1), 1-16 Fong Leung, S., Ma, J., & Russell, J. (2012). Breaking the silence of eating disorders with the hope of an online self-help programme. Contemporary Nurse: A Journal For The Australian Nursing Profession, 40(2), 245-257. Gulec, H., Moessner, M., Mezei, A., Kohls, E., Try, F., & Bauer, S. (2011). Internet-Based Maintenance Treatment for Patients With Eating Disorders. Professional Psychology: Research & Practice, 42(6), 479-486 Mayo Clinic Staff. (2012). Bulimia Nervosa Definition. Available at: http://www.mayoclinic.com/health/bulimia/DS00607

SELF-HELP PROGRAMS FOR BULIMIA NERVOSA

Smith, M., & Segal, J., (2013). Bulimia Nervosa Signs, Symptoms, Treatment, and Help. Available at: http://www.helpguide.org/mental/bulimia_signs_symptoms_causes_treatment.htm