Benefits of Prozac in Bulimia Remission: Beyond Just Treating Depression

Let’s Look into Bulimia and How We Can Tackle It with the Help of an Antidepressant

There can be a collaborative rejuvenation when working alongside a dedicated eating disorder recovery coach to help guide you toward a life full of purpose and promise. A coach is someone who dedicates their energy to nurturing the spirit within you, revealing the greater aspects of your being that’s not just your eating disorder. Discovering what your truth is, what your passions are, what you want to be besides what you struggle with. 

You are more than your pain, and that’s what people like Sarah and Merrit work so hard to prove when you work beside one another in transforming your life.

But eating disorder recovery can come in all shapes and forms, with all types of people and professionals by your side. Oftentimes, these groups overlap to become several different branches of support during treatment. 

This could be your recovery coach, your therapist, your physician, your dietitian, your family, support groups, and any other possible team combination in between that gets you back on your feet after dealing with an eating disorder.

Exploring even more additive pathways during your recovery process can also help boost you on your path toward remission. This may look like discussing with a psychiatrist or other medical professional about the possibility of adding an antidepressant to your treatment toolkit. Some known medications that have shown effectiveness in reducing binge and purge episodes include:

• Tricyclic antidepressants, one of the first types of antidepressants ever produced

• Monoamine oxidase inhibitors, another class of early antidepressants

• Buspirone, which treats anxiety^[1]

While these are a few of the known medicines that help reduce bulimic urges, these tend to not be the first pick when it comes to prescribing the best course of action. Mostly, that’s due to advancement over generations of medical science and the greater risk of adverse effects caused by these “first-generation” classes of antidepressants. 

So, What’s the Best Choice for You?

Today, doctors are more likely to go with “second-generation” classes of medication that have shown fewer side effects than previous iterations. In this case, the medication that has shown the most promise and least unwanted effects is the antidepressant known as Prozac.

A combination of factors including mental health conditions can all play a role in how disordered eating pathology manifests. Of course, not everyone who has bulimia also has depression, but studies have shown that taking an antidepressant like Prozac has shown effectiveness in reducing binge and purge episodes,^[2] with remission being achieved across multiple trials.

So even if you don’t have feelings of depression, this same medication could possibly work for you in your steps toward healing your mind and body.

As some of these same studies have also shown, however, remission might not always be long-term. Going into recovery understanding that it might not be the most perfect, linear path is where an eating disorder coach could come in to provide personalized, invaluable support that encourages you during those bumpy moments along the way. 

With a support network behind you, achieving healing and health that lasts is not just possible, but probable beyond anything in your imagination. 

Knowing what your options are when it comes to bulimia treatment and recovery is the first step in revitalizing a life away from destructive patterns and toward reclamation of wholeness and self. If you’re weighing the aspects of incorporating medication into your life, being informed about the ins and outs of the prescriptions available to you and how they work is a good place to start. 

What is Prozac?

Prozac is the brand name for fluoxetine hydrochloride, an antidepressant part of a class of medications called selective serotonin reuptake inhibitors or SSRIs. When treating depression, the medication works by inhibiting or limiting the absorption of serotonin by nerve cells in the body. Breaking that down, the process goes a little like this:

• Serotonin is thought to affect mood and emotion 

• Serotonin travels through the brain delivering chemical messages

• When they are reabsorbed after delivering their signals, levels of serotonin go down

• By blocking this reuptake, more serotonin is available to actively travel the brain

• The more serotonin, the more balanced your emotional equilibrium

While this is a very simplified version of the complexities of the brain’s inner workings, SSRIs are generally believed to work by maintaining a positive balance of serotonin in the brain which influences mood regulation. 

Because of its ability to alter serotonin in your system, Prozac has been approved by the Food and Drug Administration or FDA to treat various mental health conditions such as major depressive disorder, obsessive-compulsive disorder, and panic attacks, as well as eating disorders like bulimia and binge-eating disorder.

How Does it Treat Bulimia in Eating Disorder Recovery?

So, how does Prozac work for treating bulimia?

In actuality, studies have shown that multiple types of antidepressant classes were effective in reducing binge eating episodes^[3] when compared to using a placebo pill and that there was no statistically significant difference in which ones were more effective than the others. 

However, Prozac is the only antidepressant specifically approved to treat bulimia by the FDA in the United States. Furthermore, it has shown fewer adverse effects and risks of negative food and drug interactions^[4] when compared to the other antidepressant classes, signaling the SSRI to be a generally more stable and safer drug to take in this case.

Antidepressants like Prozac are believed to help people with bulimia nervosa as what we eat can tie back into how we think and feel about ourselves, and disordered eating can disrupt healthy mental processes if the mind-body connection becomes a toxic relationship.

The serotonin that is amplified by the help of an SSRI like Prozac is a natural mood stabilizer in the brain, and with the increased serotonin, people report feeling calmer, emotionally stable, and overall happier. In addition, much of our serotonin resides in the GI tract of our intestinal system, where it helps to protect our gut health and lower our appetite while eating.^[5]

In bulimic episodes where binging is often used to fill an emotional emptiness or numbness inside, the use of an antidepressant can possibly help switch on the feeling of fullness that the overindulgence of food provides.

Medication Pros and Cons for Eating Disorder Treatment

Like any pharmacological intervention, adding a pill treatment into the mix could cause possible side effects. While second-generation antidepressants like Prozac have been shown to have lower risks of unwanted effects or negative interactions, it’s still not 100% foolproof. Some common side effects include:

• Restlessness

• Itchy skin or rash

• Lowered appetite

• Chills or fever

• Joint pain^[6]

Rarer complications such as anxiety, headache, diarrhea, and others can also appear, but these are atypical experiences for most people taking the pill, with many having little to no adverse side effects. Even if you’re someone who does suffer from a negative symptom, oftentimes these will clear up as the body adjusts to the new medicine intake into the system. 

If any persistently negative or life-threatening issue does emerge, consulting a doctor right away in order to address the reaction is imperative.

More Things to Consider When Contemplating Medication

Something to also consider when seeking medication to help eating disorder recovery is acknowledging the potential mental and emotional conflicts that can come along when testing a new pill. Sometimes we see medication as a certified path to success, that there lies a guaranteed solution to any sickness once you find the right prescription. You might view this medication as finally being the “one” to free you from your disorder and accompanying physical, mental, and emotional effects, although there is no sure-fire pill to fix everything all at once. 

Eating disorder recovery necessitates a well-rounded approach to restoring a person’s body and mind, and a single pill alone will not create lasting remission. Oftentimes, if the pills do work, they show only limited, short-term remission as eating disorders can be tricky to fend off when only using one avenue of intervention alone.

This doesn’t mean that adding medication to your toolkit is useless or unnecessary, but it’s always important to be informed if you believe that it’s the only thing you need to do to treat your eating disorder.

Or, there can be a fear of uncertainty if the medication doesn’t seem to work. Prescription medicine is often a trial-and-error process when it comes to learning what works and doesn’t work for your body. It can take time to see how the medicine affects you, get adjusted to the dosage, and hope for positive results that outweigh the possible negatives. Setting balanced expectations beforehand should help in your journey in case certain medications aren’t right for you.

It can be devastating to believe medicine alone will finally “fix” you and your problems, only for those very same problems to rear right back up again. This doesn’t mean you’re a weak or failed person. This just means you’re someone who needs help, and those are two very different things. We all go through this world needing support at times, whether that’s by leaning on a friend or a family member, or when bigger problems arise, a professional who is trained and educated to advise you through your difficulties.

Whether it’s Medication, Therapy, Coaching, or All the Above

Be assured to know that there is always a helping hand out there for you if you’re ready to reach for it. 

With Peace,

Whitney Chase

Whitney Chase is the Writer and Content Manager for Sarah Lee of Sarah Lee Recovery. She holds her degree in Psychology from Georgia State and has a strong passion for the mental health field, writing, and advocacy work.

Posted on February 21st, 2024.

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Citations:

[1] Gorla, K., & Mathews, M. (2005). Pharmacological treatment of eating disorders. Psychiatry (Edgmont (Pa. : Township)), 2(6), 43–48.

[2] Fluoxetine in the treatment of bulimia nervosa. A multicenter, placebo-controlled, double-blind trial. Fluoxetine Bulimia Nervosa Collaborative Study Group. (1992). Archives of general psychiatry, 49(2), 139–147. 

[3] Hall, M. N., Friedman, R., & Leach, L. (2008). Treatment of bulimia nervosa. American Family Physician, 77, no. 11.

[4] Bacaltchuk, J., Hay, P., & Mari, J. J. (2000). Antidepressants Versus Placebo for the Treatment of Bulimia Nervosa: A Systematic Review*. Australian & New Zealand Journal of Psychiatry. https://doi.org/10.1080/j.1440-1614.2000.00709.x

[5] Bakshi, A., & Tadi, P. (2022, October 5). Biochemistry, serotonin. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK560856/

[6] Mayo Foundation for Medical Education and Research. (2024, February 1). Fluoxetine (oral route) side effects. Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/fluoxetine-oral-route/side-effects/drg-20063952