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Learn more about the results we get at Within

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Antidepressants and bulimia nervosa

Bulimia nervosa (BN) is a debilitating and dangerous eating disorder that can lead to numerous health complications or even death if left untreated. Bulimia nervosa can also co-occur with mental health disorders like depression. But can you use antidepressants for bulimia nervosa? 

Before getting into this article, we at Within Health want to clarify that you should always consult your doctor, and your eating disorder care team, before changing your medication plan. We are by no means encouraging or discouraging the use of antidepressants to treat bulimia nervosa. This article will unpack the research that exists on the success of using antidepressants for BN. 

 minute read
Last updated on 
March 23, 2023
Antidepressants and bulimia
In this article

Early research on using antidepressants for bulimia

There are several methods to help treat bulimia nervosa. For some people with BN, taking antidepressants can be a valuable component of treatment.1 And so far, the results are encouraging, with some studies reporting people with bulimia nervosa seeing reduced binging and purging behavior after taking antidepressants.2

Once again, antidepressants should never be used without the consultation of your medical care team. It is important to remember that there are multiple types of antidepressants, each of which works differently, and each has different effects on different people. 

Different types of antidepressants

In general, antidepressants regulate certain hormones in the brain, which can impact mood, including a reduction in anxiety, guilt, and depression. 

But there are several different ways these outcomes can be achieved, resulting in the development of several different types of antidepressants, including:6

Selective serotonin reuptake inhibitors (SSRIs)
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Tricyclic antidepressants
Monoamine oxidase inhibitors

All of these drugs have the potential to be able to help some people struggling with bulimia nervosa in their recovery process.

Treating bulimia nervosa with antidepressants

Using antidepressants for the treatment of bulimia nervosa can be beneficial.1 Most frequently, these medications can help reduce binge eating and purge cycles in people with bulimia nervosa. And while much more research on this connection is needed to establish a known cause and effect, there are a few prevailing hypotheses proposing why antidepressants may be so helpful.

Several studies have found that many people with bulimia nervosa experience a disruption in their neural pathways, resulting in a serotonin imbalance. Since this chemical impacts not only mood but many aspects of hunger, digestion, and metabolism, an imbalance could contribute to many of the symptoms behind the condition.3

SSRIs are the only type type of antidepressant currently approved for treating bulimia nervosa.

For this reason, SSRIs are the most popular antidepressant for bulimia nervosa—and, in fact, the only type of antidepressant currently approved for treating BN by the Food and Drug Administration.4

But antidepressant medication may do even more to help some people struggling with bulimia nervosa.

Depression is often diagnosed in people with BN, with a comorbid rate as high as 75%.5 And many aspects of this mental health disorder may also drive the binge eating behavior, with depression playing a role in the low self-esteem, poor self-image, and feelings of guilt that often accompany BN.

Treating the depression itself may ease the mental burden on someone struggling with bulimia nervosa, alleviating the deep emotional distress that may trigger cycles of binging and purging.

Treatment of bulimia nervosa: Other methods

Still, antidepressants aren’t the only way to treat bulimia nervosa—or depression. Multiple treatment options are available for both BN and depression, as well as their co-occurrence.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) has long been a common method for treating bulimia nervosa. This modality focuses on identifying, then changing, unhelpful thought and behavioral patterns.

The belief that the key to changing behavior is changing someone’s thoughts and feelings and the tools to help a patient identify and correct these unhelpful notions also makes CBT particularly well-suited to treat depression, whether on its own or concurrently with BN.

ACT and bulimia nervosa

Acceptance and commitment therapy (ACT) is a form of psychotherapy similar to CBT, and that is another popular way to address the underlying causes of both bulimia nervosa and depression. However, rather than focus on active change, this method promotes more active acceptance.

Patients are advised to let unhelpful thoughts come and go without much resistance. The philosophy of ACT is that energy spent on unhelpful thoughts—even when trying to change them—is better served by directly improving oneself through pursuing activities that are both meaningful to the person and in line with their personal values.

Dialectical behavioral therapy

Dialectical behavioral therapy (DBT) has a similar concept at its core: Helping patients better manage their emotions by learning to handle discomfort, developing healthy strategies for coping with stress, and improving their relationships with others. Boosted self-assurance and self-acceptance are the ultimate goals of this course of treatment, which bode well for battling both bulimia nervosa and depression.

Get help today 

Most doctors would recommend a hybrid course of treatment for eating disorders, which may include psychotherapy and medications like antidepressants when deemed appropriate. 

At Within, we tailor our treatment program to your needs, including treating any underlying mental health conditions. While looking for help, it’s important to remember that healing is possible, and it is never too late to start the process. Reach out today.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.


  1. Walsh, B. T., Agras, W. S., Devlin, M. J., Fairburn, C. G., Wilson, G. T., Kahn, C., & Chally, M. K. (2000). Fluoxetine for bulimia nervosa following poor response to psychotherapy. American Journal of Psychiatry, 157(8), 1332–1334.
  2. Bacaltchuk, J., & Hay, P. P. J. (2003). Antidepressants versus placebo for people with bulimia nervosa. The Cochrane Database of Systematic Reviews, 2003(4), CD003391.
  3. Sysko, R., Sha, N., Wang, Y., Duan, N., & Walsh, B. T. (2010). Early response to antidepressant treatment in bulimia nervosa. Psychological medicine, 40(6), 999–1005.
  4. Crow, S. J. (2021). Bulimia Nervosa in Adults: Pharmacotherapy. UpToDate.
  5. Mischoulon, D., Eddy, K. T., Keshaviah, A., Dinescu, D., Ross, S. L., Kass, A. E., Franko, D. L., & Herzog, D. B. (2011). Depression and eating disorders: treatment and course. Journal of Affective Disorders, 130(3), 470–477.
  6. US Department of Health and Human Services. (n.d.). Mental health medications. National Institute of Mental Health. Retrieved January 25, 2023.


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Further reading

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