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Author: Dr Charlie BailyClinical Psychologist

If you are concerned that your child or teenager may be suffering from bulimia, or if they have been diagnosed with an eating disorder and you are looking for professional support, we can help.

What is bulimia?

Bulimia Nervosa, most commonly known as bulimia, is a serious mental health condition that involves consuming large quantities of food (bingeing) compensated by purging behaviours, such as self-induced vomiting, laxative, diuretic or enema usage, excessive exercise or fasting.

The binge and purge cycle is then repeated – this may be several times a month or even as often as several times a day.

The average age of onset of bulimia is around 18 but can start as early as 5 years of age


What causes bulimia in teenagers and children?

Eating disorders in children and teenagers can be extremely complex – and research has suggested that they are caused by several factors including biological, genetic and environmental.

It is thought that as much as 60% to 80% of our risk in developing an eating disorder could be genetic.

Hormonal changes during puberty have been shown to be linked to an increased risk in developing eating disorders like anorexia and bulimia – it seems that hormones such as oestrogen have a role to play in how the genes that have been linked to eating disorders are expressed .

Some children may become bulimic as a way of managing difficult emotions. Bingeing on food is a way some people cope with overwhelming emotions, perhaps stress or anxiety about school performance or difficulties with relationships. The purging (most commonly in the form of self induced vomiting) is then used to rid the body of calories ingested.

Bulimia is a complex mental health disorder – the earlier treatment is sought, the more likely a full recovery can be made.

1 Wade T.D. et al (2000)
2 Klump, K.L. et al., (2017)

The whole service was incredibly professional and we really felt that the wellbeing and happiness of our daughter was put first.

Maxine, Swansea


Symptoms of bulimia in teenagers and children

Bulimia is a progressive illness, meaning it often gets worse over time.

The following are some of the most common signs that an eating disorder, such as bulimia, may be developing or has developed.

  • Obsessional thoughts about weight / thinness
  • Being tired all the time
  • Becoming secretive, especially around food
  • Reluctance or refusal to eat in front of others
  • Going to the bathroom immediately after a meal
  • Scars or marks on back of knuckles (from inducing vomiting)
  • Stomach complaints
  • Dental issues, such as enamel erosion
  • Sore throat / enlarged salivary glands
  • Becoming socially withdrawn
  • Scrutinising self in mirror
  • Exercising more or, you suspect, in secret
  • Depression, low mood, tearfulness, self harm
  • Bingeing and / or purging behaviour
  • Drug or alcohol abuse

Not all children and teenagers with bulimia will show all of these signs, and as eating disorders are notoriously a very secretive illness, it can be hard to really know what is going on for your child.

If you are concerned about your child or teen’s eating habits, weight loss, mood or behaviours we would also recommend seeking expert help as quickly as possible.


What should I do if I think my child or teenager has bulimia?

Identifying whether your child or teenager has an eating disorder and broaching the subject with them can be very challenging. Bulimia is an incredibly secretive disorder – surrounded by a great deal of shame and embarrassment and your child may get very defensive when talking about it.

It’s hard for parents to know when their child’s eating behaviours become a significant issue but research shows that early intervention is the best way to determine a full recovery.

Many young people with bulimia are simultaneously in denial about having eating difficulties and believe that the condition benefits them in some way (e.g., helps them focus, evidences self-control and determination). Be prepared for your loved one to state that they don’t have any difficulties or even to say that you are the one with a problem for suggesting as much!

Tips for discussing your child’s eating with them:

  • Note down the things that your child is doing that are causing you concern, being as specific as you can.
  • Try to find a quiet moment outside of meal times to raise these concerns in a calm and non-confrontational way.
  • Do not place undue pressure on yourself to persuade your child of the need for help in a single conversation. Instead think of it as an opening, so that you and your children can keep returning to the topic, over time talk more openly and ultimately consider seeking further, professional support.

 

Helping your child to see that he or she may have a problem and to agree to an appointment for further professional evaluation is a difficult and important first step in eating disorder recovery. It is very common for young people to become hostile and defensive when loved ones raise concern about their eating, not least if problems really are developing.
PhD, CPsychol

Clinical Psychologist
London

Dr Charlie Baily is a Clinical Psychologist currently working in the private sector. He has a PhD in Clinical Psychology and is a member of The British Psychological Society and Health and Care Professions Council.

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