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What is bulimia nervosa?

Bulimia nervosa is an eating disorder in which a child has periods of out-of-control eating called binging. After eating way too much, the child tries to reverse the binging by doing what’s called purging: throwing up on purpose, using laxatives, not eating, or exercising too much. Unlike kids with anorexia nervosa (who are usually extremely thin), kids with bulimia are usually normal weight or somewhat overweight. But the way they maintain their weight is very unhealthy. Bulimia is diagnosed more often in girls than boys and it usually starts in adolescence.

What are the symptoms of bulimia nervosa?

Children with bulimia often hide their binging and purging, so it can be hard to spot.  

Common signs of bulimia include: 

  • Eating a lot of food in a very short time 
  • Making up for eating a lot by vomiting, using laxatives, not eating at all, or exercising too much 
  • Having a self-image that is mostly focused on body weight  
  • Missing a lot of meals 
  • Rushing to the bathroom right after eating 
  • Long periods of not eating 
  • Being secretive about eating 
  • Physical effects of vomiting, including sore throat, swollen glands, acid reflux, and teeth damaged by stomach acid 

How is bulimia diagnosed?

To be diagnosed with bulimia, a child must eat large amounts of food in a short amount of time (binging) and be unable to control their binge eating. They must also try to make up for the binge eating by throwing up on purpose, using laxatives, not eating, or exercising too much. These behaviors are known as purging. Kids who are diagnosed with bulimia binge and purge at least once a week on average for three months. 

How is bulimia treated?

The first goal of treatment for bulimia is always to help the child stop binging and purging, which can endanger their health. Two kinds of therapy are most commonly used to treat bulimia nervosa: 

  • Cognitive behavioral therapy (CBT) can help kids understand what causes their binging and purging, develop a more positive body image, and change unhealthy eating habits. 
  • Interpersonal therapy focuses on how the child’s relationship with others affects their feelings and eating habits. 

If therapy alone isn’t working, anti-depressant medications are sometimes prescribed to children experiencing bulimia. Education about nutrition can also help kids learn about the health effects of bulimia and feel motivated to change their behavior. 

This guide was last reviewed or updated on December 12, 2023.