Box 14.8 NUTRITION THERAPY GUIDELINES FOR BULIMIA NERVOSA
To increase awareness of eating and satiety, meals and snacks should be eaten while sitting down; finger foods and foods that are cold or at room temperature should be avoided; and the meal duration should be of appropriate length.
■ Dieting should be discouraged.
■ Eating strategies that may help to regulate intake include balanced meals at regular intervals.
■ A high-protein and/or high-fiber snack slightly before the times of the day when the binge is most likely to occur may help promote satiety and keep blood glucose levels within normal range.
■ Clients may be encouraged to gradually introduce forbidden binge foods into their diets. This is a key step in changing the all-or-none behavior of bingeing/purging.
■ Clients who are laxative dependent are at risk for bowel obstruction if the protocol for laxative withdrawal is not implemented. A high-fiber diet with plenty of fluids helps to normalize bowel movements while the use of laxatives is gradually decreased. Stool softeners may be ordered.
■ A daily multivitamin may be appropriate if intake or variety is low.