For a 17-year-old female with bulimia, what is the best initial intervention?

For a 17-year-old female with bulimia, the best initial intervention is to start an antidepressant. This approach is supported by evidence showing that selective serotonin reuptake inhibitors (SSRIs), particularly fluoxetine, are effective in treating bulimia nervosa. They help reduce bingeing and purging behaviors as well as associated depressive symptoms, which are common in individuals with this disorder.

Starting an antidepressant directly addresses underlying issues within the context of bulimia, especially when anxiety or depressive symptoms are present. It's also a proactive strategy that can lead to more significant improvements in the patient's overall mental health and eating behaviors over time.

While hospitalization may be necessary in certain cases, particularly if there are severe medical complications or significant risks associated with the disorder, it is not the standard initial intervention for all patients with bulimia. Immediate hospitalization is reserved for situations where there are significant physical health concerns or suicidal ideation.

Anxiolytics are typically not recommended for treating bulimia as they can pose a risk for dependence and do not target the primary symptoms of the disorder effectively. Testing for substance abuse may be an important step in a broader assessment but is not the immediate intervention for addressing bulimia itself.

Starting an antidepressant allows for a therapeutic