Bulimia nervosa

The optimal follow-up programme has not been established and probably varies greatly between patients.

• Antidepressants, if used, are usually continued for at least 6 to 12 months. The goal is to promote as normal and rewarding a life as possible. This may decrease the chance of relapse. Providers may taper and then stop follow-up but they should encourage patients to return at the first sign of relapse.

• For patients receiving cognitive behavioural therapy, relapse prevention visits for 6 to 12 months are helpful in preventing relapse.

• Specific follow-up and treatment should continue for any comorbid condition (e.g., depression, obsessive-compulsive disorder, self-injurious behaviour).

• Treatment in pregnancy depends on practitioner and patient preference, as fetal risk may be higher due to untreated bulimia. Fetal health should be closely monitored. If the baby's growth stagnates, the patient should be admitted to hospital and monitored.