Clinically reviewed by Kara Becker, LMFT, CEDs, National Director of Eating Disorder Programs
Bulimia nervosa is a serious, potentially life-threatening eating disorder that should not be taken lightly. Early treatment is key to helping teens avoid long-term psychological and physical complications.
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Table of Contents
What is Bulimia Nervosa?
Teens who suffer with bulimia nervosa, known more commonly as bulimia, take part in regular episodes of binge eating followed by compensatory behaviors to prevent weight gain, such as self-induced vomiting, excessive exercise, fasting, or the misuse of laxatives or diuretics. These teens feel a lack of control during binge eating episodes and experience extreme shame and guilt about the behavior.
Bulimia can develop at any age, but often begins during adolescence or early adulthood, typically between the ages of 12 and 25. It is the second most common eating disorder among teens. One-year prevalence of bulimia nervosa is .32 percent for females and .05 percent for males.
It is a common misconception that only females struggle with eating disorders, including bulimia. However, 1 in 3 people with an eating disorder is male. Around 10 million US men will have an eating disorder at some point in their lives. Of these males, 30 percent struggle with bulimia.
What Causes Bulimia in Teens?
The exact cause of bulimia in adolescents is not fully understood, but there is evidence to suggest that genetics and biological factors may contribute to the development of teen bulimia. Having a family history of eating disorders or other mental health conditions can increase the risk. Additionally, certain neurotransmitters in the brain, such as serotonin, may be involved in regulating mood, appetite, and impulse control, potentially influencing the development of bulimia.
Teens with bulimia usually have low self-esteem and a poor body image, which makes them see their bodies inaccurately. They often believe they are in larger bodies even when they are at or below a healthy body weight. Adolescents and teens with bulimia often experience co-occurring mental health disorders such as anxiety and depression.
Additional contributors can include:
Psychological factors: Adolescents with certain psychological traits or conditions may be more susceptible to developing bulimia. These can include low self-esteem, perfectionism, body dissatisfaction, poor body image, impulsivity, and a tendency towards negative self-talk. Teens with anxiety, depression, or obsessive-compulsive disorder (OCD) may be at higher risk.
Societal Influences: Peer pressure, comparison, and a desire for acceptance and validation can also contribute to the development of disordered eating behaviors. Teens are exposed to unrealistic beauty standards daily through social media use, images that in many cases are filtered or photoshopped. This exposure can leave teens feeling “not enough” and desperate to achieve thinness, no matter the cost.
Family and environmental factors: Family dynamics and environmental factors can influence the development of bulimia in adolescents. Dysfunctional family relationships, a history of childhood trauma or abuse, parental modeling of disordered eating behaviors, and a focus on weight and appearance within the family can all contribute to the risk.
Early detection and treatment are crucial in addressing bulimia in adolescents and promoting long-term recovery. Read more about teen eating disorders here.
Signs & Symptoms of Bulimia Nervosa?
Recognizing the warning signs and physical symptoms of bulimia in adolescents is critical to preventing serious medical complications, including anemia, heart problems, missed periods in teen girls, bone loss, and heart failure.
Emotional and Behavioral Signs of Bulimia
Fixation on body image: Teens with bulimia often have an intense fixation on body shape, weight, and appearance. They may express dissatisfaction with their body and engage in frequent body checking behaviors.
Distorted body image: Teens with bulimia may have a distorted perception of their body, perceiving themselves as overweight or larger than they actually are, even if they are within a healthy and normal weight range.
Obsession with food and eating: Teens may exhibit an intense focus on food, constantly thinking about it, planning meals, or collecting recipes. They may also exhibit secretive eating behaviors, such as eating alone.
Mood swings and emotional instability: Teens with bulimia may experience frequent mood swings, irritability, and emotional instability. They may have difficulty regulating their emotions and may use bingeing and purging as a way to cope with negative emotions.
Social withdrawal and isolation: Teens with bulimia may withdraw from social activities, avoid situations involving food, or isolate themselves due to feelings of shame, guilt, or embarrassment about their eating behaviors.
Low self-esteem and self-worth: Bulimia often leads to feelings of low self-esteem, self-worth, and self-criticism. Teens may have a negative self-image and engage in self-deprecating thoughts and behaviors.
Anxiety and depression: Bulimia is frequently associated with co-occurring anxiety and depression. Teens may experience heightened levels of anxiety, panic attacks, or symptoms of depression, such as persistent sadness, loss of interest, or changes in sleep patterns.
Impulsivity: Bulimia has impulsive features and intense urges. Research shows that bulimia alters the prefrontal cortex of the brain, which is responsible for impulse control, reward processing, and self and emotional regulation. Eventually, the brain begins to associate the binge-purge cycle with a sense of happiness and relief. When these behaviors are repeated, it causes physical changes to the brain in reward processing and impulse control. These changes can make it difficult to stop bulimic behaviors without professional help.
Behavioral Signs of Bulimia
- Repetitive dieting behavior (i.e., calorie counting, fasting, avoiding certain food groups)
- Consuming unusually large amounts of food in a short period of time
- Compulsive or excessive exercise
- Social isolation
- Eating alone or in secret
- Hiding food
- Making several trips to the bathroom during or after eating
- Using laxatives, enemas, diuretics or appetite suppressants
- Self-harming behavior
Physical Symptoms of Teen Bulimia
- Changes or fluctuations in weight
- Dental problems such as tooth decay, enamel erosion, or gum disease due to frequent exposure to stomach acid
- Gastrointestinal issues (acid reflux, bloating, constipation, or diarrhea)
- Dehydration, which will appear as dry mouth, thirst, dizziness, and dark-colored urine
- Electrolyte imbalances, which can cause irregular heart rhythms, weakness, fatigue, and muscle cramps
- Menstrual irregularities or the absence of menstruation (amenorrhea)
- Skin problems (dry, dull, or discolored)
- Calluses or scars on knuckles or hands due to repeated self-induced vomiting
- Inability to regulate temperature
Psychological Symptoms of Bulimia
- Feelings of shame, guilt, and disgust about eating
- Depression
- Anxiety
- Distorted body image/dissatisfaction with body shape and size
- Expressing guilt about eating
- Intense mood swings
- Self-harm
- Suicidal thoughts
How is Bulimia Nervosa Diagnosed?
To be diagnosed with bulimia nervosa, teens must meet specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), including recurrent episodes of binge eating and compensatory behaviors, occurring at least once a week for three months, along with a persistent preoccupation with body shape and weight.
A diagnosis of bulimia is typically made by a team of psychiatric and medical professionals. An initial evaluation may involve a comprehensive medical and psychiatric history, a physical examination, and a discussion of symptoms and behaviors related to eating, weight, and body image. A psychological assessment will help determine the teen’s thoughts, feelings, and behaviors related to food, body image, and self-esteem.
Bulimia is a serious eating disorder, with potentially life-threatening consequences. It’s critical to get a diagnosis by a qualified healthcare professional, as to not delay appropriate treatment.
Importance of Treating Bulimia
Bulimia can have significant effects on physical health. Bulimia can lead to a range of physical health problems, including electrolyte imbalances, dehydration, gastrointestinal issues, dental problems (such as tooth decay and erosion), and hormonal imbalances. These can have long-term consequences on overall health and development.
Bulimia can be life-threatening if left untreated. While it is not an immediate cause of death like some other eating disorders, such as anorexia nervosa, the long-term effects and associated health risks of bulimia can be serious and potentially fatal. Bulimia can put significant strain on the heart, leading to irregular heart rhythms, weakened heart muscles, and increased risk of heart attacks. Teens with bulimia are also at an increased risk of experiencing suicidal thoughts or engaging in self-harming behaviors.
Treating Teen Bulimia at Newport Academy
It is crucial for adolescents and teens with bulimia to receive appropriate treatment from a supportive team of medical and mental health professionals.
Depending on location, Newport Academy offers specialized residential treatment for adolescents with eating disorders in relation to a primary mental health disorder. Our caring team, which includes medical doctors, psychiatrists, nurses, board-registered dietitians, individual and family therapists, counselors, experiential therapists, and academic teachers and tutors, provide both the dietary and clinical care your child needs to experience lasting recovery. Each plan is tailored to your teen’s specific needs and involves the whole family for more sustainable healing and recovery. inside. This exploration helps teens build confidence and develop a positive self-image.
Treatment for bulimia at Newport Academy typically involves a combination of the following:
Psychotherapy
Various forms of therapy, such as Cognitive-Behavioral Therapy (CBT), are often used to treat bulimia. CBT helps individuals identify and change unhealthy thoughts and behaviors related to food, body image, and self-esteem. It also focuses on developing healthier coping strategies and improving problem-solving skills.
Nutritional Counseling
Working with a registered dietitian can help teens establish a balanced and healthy approach to eating. Nutritional counseling aims to normalize eating patterns, educate about proper nutrition, and address any specific dietary concerns.
Medical Monitoring
In severe cases, medical monitoring may be necessary to address any physical complications resulting from bulimia, such as electrolyte imbalances or dehydration.
Medication
In some cases, medication may be prescribed to help manage co-occurring conditions like teen depression or teen anxiety. However, medication alone is not considered a primary treatment for bulimia and is typically used in conjunction with therapy.
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR is a highly effective technique used to help teens heal from deep trauma wounds. EMDR helps resolve and release traumatic experiences through specific techniques involving eye movement and memory.
Attachment-Based Family Therapy
We see family involvement as an essential element in an adolescent’s treatment plan. ABFT helps restore trust and connection within the family, so teens feel safe going to their parents for support as they work through the mental and emotional impacts of their eating disorder.
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Frequently Asked Questions
Where does bulimia stem from?
It is not certain what exactly causes Bulimia to occur in teens, but it can stem from psychological, biological, and/or social factors. Teens who come from families where disordered eating is patterned may be more susceptible to developing an eating disorder, and those with impulsive tendencies and body image issues are also more likely to develop the disorder.
What is a common result of bulimia nervosa?
Bulimia can have severe psychological and physical impacts on teens and if untreated can be life threatening due to repercussions of self-induced vomiting on the body. Teens can begin to retreat socially, suffer academically, and struggle to maintain positive relationships.
Do males have bulimia?
Despite the stereotype that eating disorders only occur in women, about one in three people struggling with an eating disorder is male, and subclinical disordered eating behaviors (including binge eating, purging, laxative abuse, and fasting for weight loss) are nearly as common among men as they are among women.
What does treatment for bulimia look like?
Treatment can include a combination of the following: medication, psychotherapy, and nutritional counseling.
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