Overview

Bulimia nervosa is an eating disorder characterized by out of control (aka “binge”) eating offset by fasting, extreme exercise, or purging—voiding food by self-induced vomiting or other means. Kids with bulimia, unlike those with anorexia, often maintain a healthy weight—they can even be overweight—but the way they go about maintaining that weight is anything but healthy. Like anorexia, the vast majority of those diagnosed with bulimia are female, and onset is usually in adolescence.

Symptoms of bulimia nervosa:

  • Consuming much more in a given period than average
  • Having a “sense of lack of control” or “out-of-body” experience while bingeing
  • Compensating for the binge episode by vomiting, use of laxatives or diuretics, fasting, or excessive exercise
  • Having a self-image that is dominated by body weight and appearance.
  • Bingeing and purging that occurs on average once a week for 3 months
  • Bingeing and purging in secret

Signs your child might be bulimic:

  • Dehydration
  • Abnormal intake of water
  • Acid reflux from frequent self-induced vomiting
  • Scars on her fingers from vomiting
  • Deterioration of her teeth due to contact with stomach acids
  • Sore throats
  • Swollen glands
  • Sudden absences during meals
  • Routine trips to the bathroom right after eating
  • Long periods of not eating
  • Secretiveness around eating
  • Obsession with her weight and appearance

Treatment

Psychotherapy is the first line of treatment. Cognitive behavioral therapy is often used to help reduce the person’s concerns about body image, help her understand what triggers her binge eating, and change unhealthy eating habits. Interpersonal therapy, which focuses on how the child’s relationship with others affects her feelings and actions, is also used.

If behavioral models don’t help, some antidepressants—particularly selective serotonin reuptake inhibitors or SSRIs—can help.

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