Bulimia Nervosa

What Are The Signs and Symptoms? 

It can be hard to tell if a child has bulimia. This is because people with the disorder are often at a healthy weight and binge and purge when family and friends are not around.

However, it may be possible to find signs of a binge and purge episode. Large amounts of food missing from the kitchen, several empty food containers or wrappers found in unexpected places, boxes of laxatives or diuretics, or the smell of vomit are all signs.

A child with bulimia may:

• Disappear after meals.
• Hoard food.
• Skip meals or eat small amounts of food at regular meals.
• Have a distorted body image and low self-esteem.
• Exercise excessively.
• Be sad or anxious.
• Withdraw from friends and social activities.

Other signs and symptoms of bulimia include:

• Swollen salivary glands
• Cut or callused knuckles from self-induced vomiting
• Tooth enamel erosion from contact with stomach acid during self-induced vomiting
• Gastrointestinal problems such as stomach cramps, acid reflux and constipation

Substance abuse, impulsivity and self-harm are also common in people with bulimia.

What Causes Bulimia?

Researchers are still studying the causes of bulimia and other eating disorders. It is currently thought that eating disorders might be caused by a combination of biological, genetic, psychological and social factors.

How is Bulimia Diagnosed?

The doctor talks to the child and parent about eating behaviors and other related topics and evaluates the child’s symptoms and medical history. A physical exam and blood and urine tests are also performed to make sure another condition isn’t causing the child’s symptoms.

In some cases, additional tests are done to check for complications related to bulimia.

How is Bulimia Treated?

Proper treatment for bulimia requires professional help from a multidisciplinary team of specialists. Parents must also educate themselves and play an active role in the treatment process.

Treatment may include:

• Nutrition therapy. A dietitian creates an eating plan to restore healthy eating habits and treat dehydration and electrolyte imbalance.
• Counseling. A therapist or psychiatrist who specializes in eating disorders talks to the child about his or her thoughts and feelings in an effort to change the child’s behavior. Counseling may take place with the child’s parent there or one-on-one.
• Medicine. A psychiatrist may prescribe an antidepressant if the child is also diagnosed with depression or anxiety.
• Hospitalization. Severe complications of bulimia may require hospitalization.

Recovery from an eating disorder takes time and full support from loved ones. Relapse is possible. But with love and thoughtful guidance from parents, a child can recover.

Are There Any Complications Associated With Bulimia?

Potential health complications of bulimia include:

• Loss of menstrual period (amenorrhea) and infertility in girls
• Severe dehydration, which can lead to seizures or kidney failure
• Electrolyte imbalance, which can lead to irregular heartbeat, heart failure, stroke or seizures
• Stomach damage
• Esophagus damage
• Insulin resistance, which can cause Type 2 diabetes

Many of the complications of bulimia can become life-threatening if left untreated. The mental and emotional factors related to bulimia can also lead to suicide.

When Should You Seek Help For Your Child?

Bulimia is easier to treat before it causes severe health problems. Don’t ignore the signs and symptoms.

If you find signs of binging and purging coupled with other signs and symptoms of bulimia, make an appointment with your family doctor or pediatrician to discuss your concerns.