Bulimia Nervosa in Teens

Eating disorders typically occur in adolescent males and females, but can also affect adults. All eating disorders are characterized by disturbances in eating behaviors and fears about appearance and body weight, problematic attitudes toward food, and mood disturbances. Eating disorders are mental disorders; early treatment from medical professionals is important for recovery.

Bulimia nervosa is an eating disorder. Those with the disorder tend to overeat followed by self-induced vomiting or an attempt to rid the body of the food consumed. These behaviors are often accompanied by feelings of loss of control or guilt. Bulimia nervosa in adolescents can sometimes alternate with or occur alongside anorexia nervosa.

This blog post explores eating disorders and focuses on bulimia nervosa. It outlines the signs and symptoms of bulimia nervosa, and the treatment options to support your teen toward healthy eating habits and a positive attitude to their body weight.

What Are Eating Disorders?

Eating disorders are psychological disorders that cause an individual to experience disordered eating attitudes. An obsession with weight affects millions of individuals all over the world. A study found that one in five women and one in seven men experienced an eating disorder before the age of 40, and the disorder began before the age of 25 in around 95% of these cases.

Stereotypically, when people think of an individual with an eating disorder, they tend to envision a particular body size and shape. But the truth is anyone is susceptible to the dangers of adolescent eating disorders, no matter their weight or sex. The most important thing to remember is it is a serious mental health disorder that can be extremely detrimental to a person’s physical health and affect nearly every organ system in the body.

Types of Eating Disorders

Anorexia nervosa

Anorexia nervosa is an eating disorder that is characterized by an extreme fear of weight gain. People living with anorexia nervosa tend to view themselves as being overweight, even if they are a healthy weight or extremely underweight. Those with anorexia nervosa tend to stop eating or eat extremely little in order to lose weight. Individuals are often very strict about the food they consume and their minds are preoccupied with thoughts of calories and food.

Binge eating disorder

An individual with a binge eating disorder will experience periods of intense overeating where they feel out of control and unable to stop. Binge eating causes people to eat large amounts of food, even if they are not feeling hungry. After a period of binge eating, people typically experience guilt and other negative emotions. Unlike bulimia nervosa, individuals do not try to get rid of the food they have consumed.

Bulimia nervosa

People with bulimia nervosa experience periods of binge eating followed by self-induced vomiting and other attempts to rid the body of the food they have binged. Bulimia nervosa is not just characterized by self-induced vomiting, but also includes weight loss tactics, such as laxatives, weight loss pills, or excessive exercise to prevent weight gain.

What Is Bulimia Nervosa?

Bulimia nervosa is when an individual partakes in uncontrollable periods of binge eating which are typically followed by intentional vomiting (also referred to as purging behaviors), fasting, excessive exercise, or misuse of laxatives to try to control weight.

Binge eating, for a person with bulimia nervosa, is where exceptionally large quantities of food will be eaten within a pretty short period of time, typically in less than two hours. These binges can occur several times throughout the day but are most likely to happen in the evenings. Due to the feelings of guilt, disgust, and shame that are often associated with bulimia nervosa, many people partake in these behaviors in secret and can keep evidence hidden for months.

Signs and Symptoms of Eating Disorders

Due to personal differences, the experience of symptoms of bulimia nervosa can be unique to the individual. Signs and symptoms of bulimia nervosa and other eating disorders may include:

• repeated episodes of binge eating (the quick consumption of excess amounts of food in a short time period)
• self-induced vomiting
• fasting or excessive exercise
• anxiety
• depression
• preoccupation with weight gain, body shape, and food
• overachieving or impulsive behaviors
• withdrawing from friends or usual activities
• frequent visits to the bathroom after eating

A person with bulimia nervosa can be anywhere from a low, high, to normal body weight. The size of someone does not indicate whether they have an eating disorder or not.

Causes

Similar to other mental health disorders, there is no one set cause for eating disorders. Bulimia nervosa is a complex disorder that may involve biological, behavioral, social, and psychological factors. Bulimia nervosa in adolescents is perhaps influenced by current social attitudes toward body appearance. This can cause a person to focus too much on their looks, weight, and body image.

Those with an eating disorder may have emotional or psychological problems that are likely to contribute to the disorder. This can include impulsive behavior, perfectionism, and low self-esteem. People often have a history of depression, anxiety disorder, or obsessive-compulsive disorder (OCD).

Dieting has also been recognized as a risk factor for developing an eating disorder. Starvation can affect the brain which results in mood changes, anxiety, and a reduction in appetite. Sudden weight loss and starvation can change the way that the brain works in certain individuals. This may perpetuate eating behaviors that are restrictive, making it difficult to return to normal and healthy eating habits.

Diagnosis

As a parent, you may be able to identify whether your teen is living with bulimia nervosa, however, many people with the eating disorder initially keep the illness secretive and hidden. If you are worried about your teen’s eating behaviors, it is always best to seek outside support as early intervention and treatment are both essential in preventing further problems.

The fifth edition of the diagnostic and statistical manual identifies eight different eating disorders, including bulimia nervosa. According to this edition, episodes of binge eating and the purging behaviors that follow must take place a minimum of once per week, for over three months, for a person to be diagnosed with a minor form of the disorder.

To make a diagnosis, a healthcare professional will refer to the diagnostic and statistical manual as well as consider symptoms, eating disorder behaviors, psychiatric history, and clinical observations of the person’s behavior. There are a number of medical conditions that can mimic some of the features of bulimia nervosa, therefore a complete medical evaluation is needed, including blood tests.

Health Risks

Medical complications are common for those living with bulimia nervosa as eating disorders can impact nearly every organ system in the human body. But with treatment, these complications are certainly reversible, however, if left untreated, complications can worsen over time. Some possible health complications include:

• rupture of the stomach
• scarring on the back of hands caused by putting fingers down the throat to induce vomiting
• inflamed esophagus
• swollen glands
• irregular menstrual periods
• increase risk of suicidal behavior, substance abuse, anxiety, and other mental illnesses

If you do believe your teen has an eating disorder, the National Eating Disorders Association has created an online screening tool to help determine whether it is the right time to seek professional medical help.

Treatment

There are a number of treatment options for bulimia nervosa. Medical professionals will form a specific treatment plan based on:

• severity of symptoms
• overall health, age, medical history
• individual and family opinions

Bulimia nervosa is typically treated with a combination of medical care that is focused on nutrition rehabilitation, family therapy, individual therapy, and behavior medication related to healthy eating habits. Treatment may take place on an inpatient or outpatient basis with both involving appointments with psychiatrists, therapists, and nutritionists. Early treatment is recognized as being effective in preventing more mental and physical health complications further down the line

Individual therapy will typically include cognitive behavior therapy (CBT). This revolves around encouraging people to identify and challenge unhealthy thinking and behavior patterns. Medication may also be used alongside individual therapy to help manage symptoms. And although families are not the root cause of bulimia nervosa, they do play a vital role in supporting the whole process.

Treatment at Clearfork

Clearfork Academy is a Christ-centered treatment center for teens between the ages of 13 and 18 years old. We treat a range of substance abuse disorders alongside co-occurring mental disorders, such as eating disorders. Our exceptional therapists will work with our patients to encourage positive life-affirming behaviors that are lasting for change. We offer several levels of care to help heal from bulimia nervosa including:

Residential Treatment: This program is often recommended for patients with eating disorders to stabilize their health, monitor their vitals and receive 24/7 care & supervision. 

Partial Hospitalization: Our PHP intensive day program will meet with teens 4 hours a day, where they will participate in evidence-based therapies such as CBT, DBT, EMDR, art & music therapy, family therapy and group therapy. It provides similar levels of structure to residential, but allows teens to return to the comfort of their homes in the evening. 

Intensive Outpatient: Recovery from an eating disorder does not just stop after exiting residential treatment. Our IOP ensures teens receive long-term support and ongoing care that they need to prevent symptoms from coming back. Teens will meet multiple times a week on an outpatient basis to continue building healthy coping skills, checking in on their health and setting goals for both in & outside of treatment. 

If you are worried about your teen and their mental health, contact us today to see how we can support you and your loved one throughout the recovery process. We are here to provide life-saving treatment for youth struggling with eating disorders.