Bulimia

What Is Bulimia?

Bulimia is an eating disorder. People with bulimia (boo-LEE-mee-uh) often eat large amounts of food over short periods of time (binge eat). Then, to try to prevent weight gain they might:

• Make themselves vomit.
• Exercise compulsively.
• Skip meals.
• Take laxatives or use enemas.
• Use diet pills or diuretics (water pills).

Often, bulimia begins during the teen years. It’s more common in females, but boys can have bulimia too.

What Are the Signs of Bulimia?

Overeating followed by unhealthy behaviors to prevent weight gain are the two main signs of bulimia (also called bulimia nervosa).

Kids and teens with bulimia may:

• have yo-yo weight changes, up or down. Not all people with bulimia have significant weight changes.
• make excuses to go to the bathroom right after meals
• spend a lot of time exercising or working out
• have low self-esteem and judge themselves based on weight
• eat alone and avoid social situations that have food

People with bulimia are more likely to have anxiety, obsessive-compulsive disorder (OCD), or depression. Smoking, alcohol or drug use, and cutting are also more common with bulimia.

What Problems Can Happen?

The frequent vomiting and unhealthy behaviors of bulimia can cause:

• dizziness and other signs of dehydration
• swollen cheeks
• belly bloating or pain
• blood in vomit or poop
• tooth decay and gum problems
• missed menstrual periods

Bulimia can cause serious stomach, heart, and kidney problems. Doctors may order blood tests, urine tests, or an electrocardiogram (ECG) to check for problems.

What Causes Bulimia?

The exact cause of bulimia isn’t known. Many experts believe that a combination of psychological and genetic factors and social ideas about body size can lead to the condition.

How Is Bulimia Diagnosed?

If a doctor thinks a child or teen might have bulimia, they'll do an exam, take a medical history, and ask about eating, exercise habits, and emotional issues.

Doctors and mental health professionals will look for signs such as:

• eating more food than most people eat in a set period of time
• a sense of lack of control over eating
• binge eating, on average, at least once a week for at least 3 months
• regularly using unhealthy behaviors to prevent weight gain, such as vomiting, misusing laxatives and other medicines, fasting, or excessive exercise
• feelings of disgust or guilt after binge eating

People with bulimia are usually ashamed and try to hide what they are doing. But finding out about bulimia early is the best way to successfully treat it.

If you think your child might have bulimia, talk to your doctor right away.

How Is Bulimia Treated?

Bulimia is best treated by a team of doctors, dietitians, and therapists. Treatment includes nutrition counseling, medical care, individual or group therapy, and family-based treatment. 

The main goals of treatment are to:

• Stop the bingeing and unhealthy behaviors (such as vomiting and laxative use).
• Achieve and maintain a healthy weight and healthy eating patterns.
• Learn ways to change thoughts about their body and their approach to food.

Doctors might prescribe medicines to treat anxiety, depression, or other mental health concerns, if needed.

Most kids and teens with bulimia can be treated at home, but some will need to go to a more intensive day or residential treatment program. Someone with severe dehydration or other serious health issues will need treatment in a hospital.

With the right treatment and support, kids and teens with bulimia can make a full recovery. Relapses (when symptoms come back) can happen, so it’s important to talk to the doctor or therapist to get back on track as soon as possible.

How Can Parents Help?

Family members can play a key role in helping their child recover from an eating disorder and return to a healthy weight. Bulimia is linked to strong emotions and worries about body size and shape. Help your child have a healthy body image. Be supportive and encourage positive attitudes about exercise and nutrition at home. Try these tips:

• Be a role model. Don’t criticize your own weight, body, or looks. Talk about your body in positive ways.
• Avoid talk about weight or weight shaming your child.
• Focus on a healthy lifestyle. Encourage everyone in your family to be active every day and eat a varied diet.
• Set regular mealtimes. Skipping meals and limiting calories can trigger binge eating. 
• Identify other triggers. Stress, mood, and poor sleep can lead to unhealthy eating behaviors. Ways to manage stress and improve mood include music, art, dance, writing, or talking to a friend. Yoga, meditation, or taking a couple of deep breaths also can help your child relax.

If you are concerned your child may have an eating disorder, call your doctor for advice. The doctor can recommend nutrition and mental health professionals who have experience treating eating disorders in kids and teens. You also can find support and more information online at:

• The National Eating Disorders Association (NEDA)
• National Association of Anorexia Nervosa and Associated Disorders
• National Alliance on Mental Illness (NAMI)