Q: My 17 years old daughter is bulimic and vomits out her food after every meal. She is addicted to dulcolax laxatives for the last year. Now she is on a psychiatric treatment and taking anti-depressants and counselling. However, there is not much improvement in her thinking. She still vomits and takes laxatives. My husband is an alcoholic and is not bothered. Please help.

A:Bulimia is an addiction! There is a genetic factor as your husband is an alcoholic!

Let us address your daughter's issue of purging. There are 3 issues of this illness that needs to be addressed. It is nice that psychiatric issue is addressed by a doctor and that she is comfortable with her treating physician. Antidepressant is a good choice at this time. It would have been helpful to know which one she is on.

All 3 psychiatric issues i.e., stress, depression and low self-esteem need to be addressed and that is covered well by Prozac - up to 80 mg daily, along with counselling. Also get nutritional counselling to address her diet and maintenance of her weight.

The one main factor not addressed is seeing an addiction psychiatrist and that is most important. I use Naltrexone 50 mg daily and have seen great benefit in my practice. Try to address the addiction component and you will see the improvement. Good luck!