DEAR ABBY: My wife has recently become bulimic, and it is having an impact on our family. I have looked into treatment centers where patients can go for two to six weeks and receive constant care and help, but they are very expensive. Where can someone go to get help that does not cost an arm and a leg? -- NEEDS HELP FAST IN CALIFORNIA
DEAR NEEDS HELP FAST: The first thing you must do is see that your wife is examined by her medical doctor to determine whether the bulimia has harmed her body. Then she needs to be evaluated by someone who treats bulimia to find out how serious her problem is. Inpatient treatment is expensive, but your wife's condition may not be so serious that it is warranted.
A daytime program in which she could return home at night might work for her, and it is less expensive. Another possibility would be ongoing therapy once or twice a week, which is even less costly. Some programs charge on a sliding scale.
Public agencies such as the Department of Social Services or Mental Health Services may have therapists who are qualified to treat bulimia at reduced rates. Or depending upon your family's financial situation, she might qualify for treatment under Medicaid.
An organization that may be able to guide you is the National Association of Anorexia Nervosa and Associated Disorders Inc. (ANAD). While ANAD does not offer treatment, it does provide information about self-help groups, therapy and referrals to professionals. For more information, visit its Web site at � HYPERLINK "http://www.anad.org" ��www.anad.org� or call (847) 831-3438.