The teen years are a time of major transitions, and it’s for that reason that teens are at increased risk for developing certain eating disorders, such as teen bulimia nervosa.
It’s common to picture someone with an eating disorder as dangerously thin, but not all people with eating disorders produce such obvious changes.
Someone suffering from bulimia nervosa may not appear to be losing weight and could even be overweight, but that doesn’t mean that person is healthy.
Take a look at some of the signs of bulimia that you should be aware of and what you need to know about treatment for a teen suffering from bulimia.
Types of Teen Bulimia Nervosa
Even if you’re familiar with bulimia, you may not realize that there is more than one type of bulimia that could affect your teen.
The two main types of bulimia nervosa are purging type and non-purging type.
Purging type bulimia is the one that many people are more familiar with. In purging type bulimia, the person with bulimia binge-eats then attempts to compensate for the bingeing by purging.
Purging often involves vomiting, but not always. Those with bulimia may also abuse laxatives, enemas, or diuretics in order to purge.
Non-purging type bulimia is when the bulimic person compensates for food binges through other means, like excessively exercising or fasting. People who have non-purging type bulimia may still occasionally purge through vomiting or other means, but it’s not their primary means of compensating for overeating.
Symptoms of Bulimia
While bulimics may not necessarily become obviously underweight, there are physical symptoms of the disorder that may be noticeable.
For example, people with bulimia nervosa may experience frequent fluctuations in their weight.
Purging-type bulimics may have:
- Broken blood vessels in their eyes
- Oral trauma, like lacerations in their mouth or throat from frequent vomiting
- An inflamed esophagus
- Swollen glands in the neck and under the jaw
Bulimics may also suffer damage to their teeth from frequent vomiting – the acids in the vomit eat away at the tooth enamel.
Bulimics may experience chronic dehydration – particularly if they use diuretics – and electrolyte imbalances. They may develop ulcers or gastric reflux. They may also struggle with infertility.
There are non-physical symptoms of bulimia as well. When you live with a person who has this disorder, you may notice that large amounts of food disappear without explanation. The affected person may eat in secret and keep caches of food hidden in places around the house.
The person with bulimia may seem out of control when they eat, alternate between eating large amounts of food and eating nothing at all, or frequently disappear into the bathroom after meals. You may notice that the person smells of vomit or keeps large quantities of diuretics, laxatives, or enemas.
Causes of Bulimia
Doctors don’t know exactly what causes teen bulimia nervosa. The most likely explanation is that a confluence of genetic, environmental, psychological, and cultural factors contribute to the disorder.
Some of the factors that contribute to the development of bulimia include:
- A history of abuse or trauma
- A negative image of one’s own body
- Low self-esteem
- A period of stress or a significant transition
- Belonging to a profession, activity, or association that places a high value on physical appearance or low body weight (gymnastics are one example)
Effects of Bulimia
Teen bulimia nervosa can have a profound effect on the lives of the youth suffering from it, as well as the lives of people around them.
Those with the disease may experience loneliness and social isolation.
People with bulimia often feel compelled to hide both how they eat and how they compensate for what they eat, and the result is that they end up spending a lot of time alone, often at the expense of other relationships.
It’s not uncommon for a bulimic person’s relationships with family, friends, and partners to suffer because of their disorder.
People with bulimia may experience financial problems, as a result of spending large amounts of money on food, or as a result of job loss. Bulimia can also drain the bulimic person’s energy and focus, leaving them unable to concentrate and perform well at work, school, or other activities.
People with bulimia often struggle with sleep and purge at night, and sleep deprivation can lead to a host of other physical, emotional, and practical problems.
People with bulimia may also be prone to developing drug or alcohol addictions as a result of attempting to self-medicate for the physical effects of the bulimia or for the emotional issues contributing to the bulimia.
How Teen Bulimia Nervosa is Treated
Treatment for bulimia nervosa requires a multi-pronged approach because the disorder isn’t caused by one single factor.
Depending on how advanced the bulimia has become, the bulimic person may need medical treatment for the effects that bulimia has had on their body. For example, electrolyte imbalances can cause heart problems, including arrhythmia or cardiac arrest, that could be deadly if not treated properly.
Ulcers and gastric reflux can become painful symptoms that need to be treated. Ensuring that the person with bulimia is medically stable is an important part of treatment.
Because teen bulimia nervosa is closely tied to the bulimic person’s self-esteem and body image, therapy is an essential part of breaking the cycle and restoring a healthy eating pattern.
The first thing that the bulimic person must learn to do is break the cycle of binging and purging, fasting, or exercising.
Then they will need to work on recognizing harmful or obsessive thoughts about weight, body shape, and food, and changing those thoughts into something healthier and less harmful.
Finally, the person will need to identify and heal from emotional issues that may be connected to the disorder – this could mean addressing past traumas in therapy, learning new ways to resolve conflicts, repairing or discarding relationships that have become toxic, or learning how to manage feelings of being out of control without resorting to binging, purging, or other harmful behaviors.
A therapist who has experience treating teens with eating disorders can help get to the root of these issues using cognitive behavior therapy, dialectic behavior therapy, and other types of therapies.
Bulimia nervosa is a dangerous disorder that requires prompt treatment.
If a teenager in your life is showing signs of bulimia, it’s important to ensure that they receive appropriate treatment and therapy as soon as possible.
Common Questions About Eating Disorders
1. Are There Different Types of Bulimia?
Yes there are two different types: purging and non-purging.
2. What Are Some Factors that Contribute to Bulimia?
Genetic, environmental, psychological and cultural factors all contribute to eating disorders. For example, negative self-image and esteem, stress, or history of trauma can all lead to an eating disorder.
Dr. Nalin is a Licensed Clinical Psychologist, and Founder and Executive Director of Paradigm Treatment Centers, who has been a respected leader in the field of adolescent mental health for more than 20 years. He received his undergraduate degree from the University of Southern California, his Master’s degree from Loyola Marymount University, his Doctoral degree from Pacific University’s APA approved Clinical Psychology program, and completed his training at the University of California, San Diego’s APA approved psychology internship program.
Dr. Nalin has provided training and mentoring to students entering the field of psychology at institutions of learning including Pepperdine University’s Graduate School of Education and Psychology, UCSD, Pacific University, and Santa Monica College. He was also instrumental in the development of the treatment component of Los Angeles County’s first Juvenile Drug Court, which now serves as a national model.
Dr. Nalin has appeared as an expert on shows ranging from CBS News and Larry King, to CNN, The Today Show and MTV. He was also featured in an Anti-Drug Campaign for the Office of National Drug Control Policy (ONDCP).
Dr. Nalin is a Diplomate of the National Institute of Sports Professionals and a Certified Sports Psychologist as well as a Certified Chemical Dependency Intervention Specialist. He lectures and conducts workshops nationally on the issues of teen mental health, substance abuse prevention, and innovative adolescence treatment.
In 2017 Dr. Nalin was awarded The Sigmund Freud Foundation and Sigmund Freud University’s Distinguished Achievement Award in recognition of his work with youth in the field of mental health over the course of his career.