The discovery that antidepressants can help relieve symptoms of bulimia represents a major medical success story. Treatment with antidepressants is one of the few drug strategies shown to be of any value in managing this illness. In fact, scientific studies have found that use of these medications can reduce bingeing frequency by as much as 70 percent.

As we have seen, there are connections between eating disorders and depressive disorders. Studies have shown that between 25 and 80 percent of eating disorder patients have major depression either currently or as part of their history. Of course, the distress of bulimia, like any chronic illness, can cause its victims to feel depressed. That’s a normal reaction, but feeling sad because one is struggling with an illness is a totally different problem from clinical depression. In fact, studies show that in about half of the cases, depression starts a year or more before the bulimia even shows up.

Also, when we look at the relatives of eating-disordered people, we find a much higher incidence of affective disorders than in the normal population. Such findings suggest that susceptibility to these illnesses runs in families.

It’s tempting to conclude that antidepressants only seem to work on bulimia because they treat the underlying mood disorder that so many patients also suffer from, but the evidence shows otherwise. Several studies specifically screened out those bulimic patients who also had depression. Even in the non-depressed group, the medications produced good results. For that matter, some studies found that depressed patients using these medications actually improved less in their eating disorder symptoms than the non-depressed group.

Even though these medications are called “antidepressants,” it doesn’t mean that eating behavior improves because depression lifts. There may be some bulimic people who benefit because the medications change the chemical systems that regulate feelings of hunger and satiety.

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