What is the best initial treatment for compulsive eating followed by purging?

The best initial treatment for compulsive eating followed by purging, which is indicative of a potential eating disorder such as bulimia nervosa, often involves addressing the underlying psychological and physiological aspects of the disorder. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), have shown efficacy in treating bulimia nervosa by reducing binge-eating and purging behaviors, improving mood, and addressing any underlying anxiety or depressive symptoms. Studies have established that SSRIs can significantly reduce the frequency of the episodes associated with this eating disorder.

While psychotherapy can be important in the overall treatment plan, typically cognitive-behavioral therapy (CBT) is considered a first-line approach, the immediate use of pharmacological intervention can help stabilize the patient’s condition, especially if they present with significant mental health issues concurrent with the eating disorder. Hospitalization might be required in cases where there are medical complications or severe malnutrition, but for many patients, starting with medication to manage symptoms can be a more appropriate initial step. Anxiolytics are generally not the primary treatment choice for eating disorders and may not address the core issues effectively.

Utilizing antidepressants as an initial treatment aligns with current clinical guidelines aimed at providing rapid relief for the symptoms of the disorder