Quick Guide to Bulimia Nervosa

Bulimia nervosa is an eating disorder in which a child has periods of eating large amounts of food in a short amount of time, or binging. The child then tries to reverse the binging by doing what’s called purging: throwing up on purpose, using laxatives, not eating, or exercising too much. Kids with bulimia usually weigh as expected or more than expected for their age. 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.

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 

To be diagnosed with bulimia, a child must eat large amounts of food in a short amount of time (binging) and feel a lack of control over their eating during that time. 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. 

The first goal of treatment for bulimia is to help the child stop binging and purging, to improve their health and safety. 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.