Bulimia Nervosa is a mental health condition that causes teens to become obsessed with how much they weigh and their ability to lose weight. Bulimia is most often characterized by cycles of “binging” and “purging” – eating a large amount of food only to induce vomiting to reduce the associated intake of calories. Teens who are suffering from Bulimia may also over-exercise, use laxatives, use diuretics, or follow extreme diets in an attempt to shed weight.

It is far more common for bulimia to impact teen girls, often as a result of intense social pressures to be thin. However, the condition can and does affect a small number of teen boys, especially if they are involved in competitive sports and other high-performance activities where their weight is scrutinized regularly.

What Does Teen Bulimia Nervosa Look Like?

  • Teen Bulimia Nervosa manifests as extreme obsession with body weight and physical appearance with a special focus on binging and purging.
  • Behaviors tend to be cyclical in nature, starting with periods of binging and ending with intense purging, sometimes after every meal. Teens often attempt to hide their behaviors from loved ones because they feel a great deal of shame.
  • Because teens with Bulimia may continue to ingest at least some calories during their purging cycle, they may not lose an excessive amount of weight. However, rapid periods of weight loss are common and can negatively impact health.
  • Teens with Bulimia frequently struggle with body image and have decidedly negative feelings about their appearance and how it affects them socially. They may exhibit intense social anxiety or engage in ritualistic appearance-driven behaviors.
  • It is exceptionally common for Bulimia to be co-diagnosed with other conditions, such as Depression or Anxiety. Teens may be diagnosed with these issues long before Bulimia is even identified.

Signs of Teen Bulimia Nervosa

Sore, inflamed or irritated throat

Constant washroom visits after meals

Dental erosion or tooth issues from acid wear

Stomach pain, cramping, or acid reflux issues

Salivary gland irritation and digestion issues (e.g., IBS)

Dehydration and electrolyte imbalances (hypokalemia)

What Are The Causes of Teen Bulimia Nervosa?

Researchers aren’t yet sure exactly why some teens develop Bulimia Nervosa, but studies do tell us what experiences or situations may increase your teen’s risk for the disease. Psychological and emotional issues, such as trauma from bullying or PTSD from child sexual abuse, may play a role in eating disorders. Teens with the condition are frequently “sensitive” to criticism, prone to shame, or self-loathing, too.

We also know that excessive dieting and extreme social pressures to remain thin can damage self-image to the point where Bulimia develops. Obsessive behaviors like calorie-counting, weight management, and meticulous self-image may become addictive, leading teens to experience complex cycles of binging and purging to maintain control. Genetics may also increase the risk for standard dieting to turn into maladaptive Bulimia Nervosa.

Another condition, Body Dysmorphia, causes teens to interpret their mirror image as being heavier or larger than it really is. It isn’t yet clear whether dysmorphia is psychological, neurological, or genetic in nature, but the impacts remain the same.

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How Can I Help My Teen With Bulimia Nervosa?

The best way to help your teen with Bulimia is to seek help from professionals who understand the disease. The reclusive nature of Bulimia means that your teen may tell you you’re fine, even if they aren’t really fine on the inside. For this reason, it is imperative to get help quickly. Left untreated, Bulimia can cause devastating and life-threatening side effects that impact physical and mental wellness long-term. Some of these issues may be fatal.

As an ally to a teen who is in treatment for Bulimia, arming yourself with knowledge will also help you to provide better support. Get to know the disease, how it presents, how it is treated, and how you can best help your teen recover. Topics like healthy eating, positive self-image, self-esteem, healthy eating habits, and obsessive-compulsive behaviors all play a role in Bulimia and how teens experience it.

With the right support, many teenagers are able to change how they think about the food they eat and the behaviors they engage in. However, support at home is rarely enough – professional intervention is almost always needed.


Of all teens with Bulimia have comorbid Depression diagnoses


Americans struggle with eating disorders on any given day


Of all teens with Bulimia never receive treatment, suffering in silence

What Types of Teen Anxiety Treatment Are Available?

Teen Anxiety treatment comes in many formats. Therapists generally try to match the treatment with the type of anxiety for best symptom resolution. If symptoms are severe enough to interfere with daily life, or if symptoms prevent the teen from accessing other therapies, your doctor may want to try medication first to lessen intense emotions.


Psychotherapy, more commonly known as talk therapy, gives you a non-judgmental safe space in which you can share your feelings. Therapists can help you reprogram your thoughts and change self-destructive behaviors that limit healthy and productive thinking. Over time, talk therapy can be enough to break triggers and identify the root cause of Anxiety.


When Anxiety symptoms become so severe that you are no longer able to cope with everyday tasks, such as attending school or hanging out with friends, medication is often required. Doctors treat Anxiety using a long list of medications, including benzodiazepines, SSRIs, SNRIs, and other mood-stabilizing drugs.

Alternative Treatments

You may also benefit from relaxation techniques, including massage, meditation, yoga, acupuncture, acupressure, aromatherapy, breathing exercises, or simply indulging in activities you enjoy. Transcranial magnetic stimulation may also help a number of Anxiety patients when other options fail to reduce symptoms.

What Types of Teen Bulimia Nervosa Treatment Are Available at Paradigm San Francisco?

At Paradigm San Francisco, our job is to help teens restore their confidence and end unhealthy binging and purging cycles by creating a safe space for healing. Every treatment path is unique, but most begin with therapy to help teens understand why their relationship to food, eating, and dieting is so unhealthy in the first place. This includes teaching teens the differences between healthy and disordered eating. Teens also learn about body dysmorphia, distorted thoughts, how to engage in positive self-care, and how to correct thoughts related to body dysmorphia.

Talk Therapy

Talk therapy is an incredibly important element in teen Bulimia Nervosa treatment. Therapists work one-on-one or in groups with teens to teach them how to identify their feelings and change unhealthy relationships with food. Teens develop healthy eating schedules and learn how to portion food to remain healthy without skewing into old binging and purging behaviors.

Therapists also use specific strategies, such as Cognitive Behavioral Therapy (CBT) or Dialectical Behavioral Therapy (DBT) to teach teens how to identify negative self-talk or emotions. Then, they teach teens how to replace them with healthier, more positive messages of self-care. Like a foundation on a house, this gives teens the support they need to stand in their own skin without constant anxiety about weight or appearance.


Medication cannot cure Bulimia Nervosa, but it can help teens cope with uncontrollable negative emotions associated with it, such as Anxiety or Depression. These comorbid conditions may make treating Bulimia much more difficult, not to mention causing significant suffering for the teens who experience them. The goal of medication is always to facilitate therapy; it should not be considered a “quick fix.”

Developing a Support Network

At Paradigm San Francisco, we believe in healthy support systems. Above all else, we help teens create in-depth support networks, including friends and family, to ensure that teens graduate out of your programs and return to a healthy, healing environment at home. Family therapy and group therapy with either or both of these parties helps everyone involved answer questions or get support so that they can best support teens long-term.

The team at Paradigm is nothing short of amazing. They work diligently together to create an open, safe, honest space for the adolescents, siblings and parents to begin to rebuild their relationship with themselves and each other after the traumas of drug abuse, depression, anxiety, eating disorders and more.

– Linda

Frequently Asked Questions About Teen Bulimia Nervosa

Can my teen die from Bulimia Nervosa?

Bulimia can be a fatal disease if symptoms and behaviors become severe enough. It is important to remember that eating disorders are the exact opposite of healthy eating; when you engage in binging and purging, you can cause your body physical harm. Excessive binging and purging stresses organs like the heart, liver, and kidneys, and may lead to malnourishment or even organ failure over time. Hospitalization is another possibility, as are heart attacks and strokes as a result of constant electrolyte imbalance. Irregular heartbeat, stomach rupture, kidney failure, or throat cancer from constant vomiting and acid reflux can also occur.

Does my teen have to attend inpatient treatment to recover?

You have many options when it comes to treating your teen’s Bulimia Nervosa, including inpatient and outpatient options. The most important thing is to seek help quickly and stick with therapy or other treatment options long-term. However, inpatient treatment is often best because teens will go to great lengths to hide Bulimic behaviors, which can be misinterpreted as healing or a reduction in symptoms. In reality, the teen becomes sicker and sicker privately, hiding symptoms until serious physical and emotional issues become impossible to ignore. By coming to our facility, teens shed daily distractions and stressors while also immediately gaining access to round-the-clock support so they can engage in and focus on healing. We find this is the most effective and reliable method for treating teens with Bulimia Nervosa.

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