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Bulimia in Teens: Causes, Symptoms, & Treatment

Teen girl with pizza and fries, highlighting bulimia in teens and the struggle with binge eating and purging behaviors.

Bulimia nervosa, commonly known as bulimia, is a serious but treatable eating disorder. It causes teenagers to have a negative relationship with food. Teenagers are especially vulnerable to developing eating disorders because of factors like teasing. It can be alarming for any parent to witness their teen struggle with an eating disorder. Bulimia is less common compared to other eating disorders like teen anorexia nervosa. However, it can have the same debilitating impacts on your teen’s life. 

This article will help parents understand bulimia in teens. It will highlight its causes, symptoms, and treatment options and offer practical strategies for helping their teens. If you would like immediate assistance, contact Nexus Teen Academy. Our team will be happy to offer your teen the help they need. 

What is Teen Bulimia Nervosa?

Teen Bulimia Nervosa

Bulimia nervosa is a severe eating disorder that is characterized by binge-eating episodes followed by purging behavior. This means teens with bulimia consume large quantities of food at a time and then use methods like vomiting or laxative use to expel the food from their system. While bulimia is a more common eating disorder in teen girls than teen boys, it can occur in either gender.

If your teen has bulimia, they will often feel like they have no control over their actions. They cannot control how much they eat and will usually purge to prevent weight gain. While these behaviors can be alarming, remember that bulimia is treatable. 

Clinical Definition of Bulimia

The Diagnostic and Statistical Manual of Mental Disorders provides criteria for diagnosing bulimia. In order for your teen to be diagnosed with bulimia nervosa, they must fit the following criteria: 

  • Recurrent binge-eating episodes occur when teens consume a large amount of food within a two-hour period. The binge-eating episode should make your teen feel out of control, meaning they cannot stop eating even when they feel full. 
  • Recurrent corrective behavior, such as self-induced vomiting or the use of laxatives to prevent weight gain. 
  • The recurrent binge-eating and purging behavior should occur at least once a week for three months. 
  • Body image issues cause teens to evaluate themselves unfairly based on their shape or weight. 
  • These binge-eating and purging behaviors should not occur during an episode of anorexia nervosa. 

The DSM-5 also includes the following to measure the severity of a teen’s bulimia: 

  • Mild cases of bulimia nervosa should occur between one and three times a week.
  • Moderate cases involve between four and seven instances of binge-eating and purging behaviors per week. 
  • Severe cases of bulimia can include eight to thirteen episodes of binge-eating and purging behavior. 
  • Teens with extreme bulimia experience more than fourteen episodes a week.

How Common is Bulimia in Teens?

According to the Rochester University School of Medicine, it is estimated that bulimia affects around 1% to 4% of teenagers. It is more common in teenage girls. It also affects teenagers equally across all socioeconomic and ethnic backgrounds. However, a recent study reviewing the number of hospital visits that are related to eating disorders found that the prevalence of eating disorders has more than doubled. The number went from less than 50,000 to more than 100,000 visits. This study did not narrow down the prevalence of bulimia in teens. However, if the statistics are accurate, it means that the number of teens with bulimia has increased in the last five years. 

Common Causes and Risk Factors of Teen Bulimia

The exact cause of bulimia remains unknown. However, scientists believe that the following factors may contribute to the development of the condition:

Psychological and Emotional Factors

Teenagers with mental health conditions like obsessive-compulsive disorder (OCD) are more likely to develop bulimia nervosa. OCD can cause your teen to have obsessive thoughts about perfection. These thoughts are intense and do not go away until your teen performs a compulsive act. As a result, your teen may chase a perfect body. This causes them to binge-eat and purge to create an ideal physique. 

Similarly, teens with body image issues may develop bulimia. During adolescence, teens can become obsessed with how they look. They begin nitpicking “imperfections.” In order to achieve the body type they want, they may engage in inappropriate eating habits that can lead to bulimia nervosa.

Societal and Environmental Influences

Over the years, society has glamorized certain body types. This standard keeps shifting from one body type to another. As a result, teenagers may begin engaging in appropriate eating habits to achieve the ideal body type. In most societies, a slender figure is deemed to be more desirable. In these societies, girls are pressured to look a certain way. This can cause your teen to develop disordered eating habits. 

Additionally, if your teen has been victimized about their appearance, they may develop disordered eating habits. During adolescence, teenagers become sensitive to comments about their appearance. Bullies tend to harass people based on superficial attributes like weight, shape, or looks. As a result, victims of bullying may develop disordered eating habits like bulimia to cope with bullying. 

Biological and Genetic Factors

Chemical imbalances in the brain can cause bulimia. Neurotransmitters like serotonin and dopamine not only affect mood but also control appetite. An imbalance in these chemicals can cause teenagers to consume large quantities of food and then purge to prevent weight gain. Similarly, teens with first-degree relatives with bulimia and other mental health conditions are likely to develop disordered eating habits. 

Recognizing Symptoms and Warning Signs of Bulimia in Teens

Recognizing Symptoms and Warning Signs of Bulimia in Teens

Bulimia can be life-threatening if left untreated. As a result, parents need to educate themselves on what to look out for when they suspect their teen has disordered eating habits. Teens with bulimia nervosa may exhibit the following signs and symptoms: 

Behavioral Symptoms

  • Secretive eating habits. Many people with bulimia become secretive to hide their disordered eating habits. Some never get diagnosed until they are in their 30s. 
  • Excessive concern about body weight 
  • Disappearing after meals, usually visiting the washroom for an extended period
  • Unusual eating rituals, like eating large quantities of food at a time 
  • Exercising a lot 
  • Excessive fasting 
  • Irregular or absent menstrual periods

Physical Symptoms

  • Fluctuating weight 
  • Erosion of the tooth enamel due to repeated attempts to induce vomiting 
  • Stomach aches and other gastrointestinal issues 
  • Cuts and bruising around the knuckles
  • Swelling of the cheeks or jaws
  • Throat inflammation 

Emotional and Psychological Symptoms

  • Excessive guilt or shame 
  • An intense fear of gaining weight 
  • Irritability and mood swings 
  • Increased anxiety and depression 
  • Binge-eating to relieve anxiety
  • Obsession with body weight
  • Feeling out of control, helpless, or hopeless

Diagnosing Bulimia Nervosa in Teens

Mental health practitioners use the Diagnostic and Statistical Manual of Mental Disorders to diagnose bulimia. If your teen meets the criteria laid down in the DSM-5, they will receive a formal diagnosis. Other than the DSM criteria, teens are required to undergo further medical evaluation to rule out other physical conditions that may cause disordered eating habits. Tests such as an electrocardiogram, urinalysis, and a kidney function test will be run to evaluate the effects of bulimia on your teen’s body. 

Diagnosing bulimia can be challenging. Teens with bulimia are very secretive about their mental health struggles. Many people do not receive their diagnosis until they are in their thirties. As a result, parents need to pay attention to their teens’ behavior to ensure early detection and treatment. 

Effective Treatment Options for Teens with Bulimia

Bulimia is a treatable eating disorder. The goal of treatment is to address the underlying causes of bulimia. Some effective treatment options for teens with bulimia include the following: 

Nutrition Education

Nutrition education or counseling is an effective way of treating eating disorders like bulimia. It involves a multidisciplinary team whose goal is to help teenagers reach a healthy weight. Nutrition counseling educates teens about healthy eating habits. During a session, your teen will be taught the importance of adequate nutrition and how to overcome negative feelings towards food. 

A nutritionist or dietitian will create a treatment plan and a meal chart incorporating different food groups into your teen’s diet. Each session will address the underlying causes of disordered eating while encouraging teens to adopt healthier eating habits. 

Cognitive Behavioral Therapy (CBT)

Teen CBT is a popular psychotherapy approach that teaches teenagers to identify and modify negative thought patterns. Teens with bulimia may have negative thoughts about themselves. CBT helps teens recognize that their way of thinking is problematic and that it will lead to negative consequences. Cognitive restructuring, a core tenet of CBT, allows teenagers to replace negative thoughts with more positive ones. It also equips them with skills that help them manage their emotions and cravings. CBT is an excellent way of helping teens with bulimia overcome their struggles. 

Family-Based Treatment (FBT)

Bulimia affects teens, their families, friends, and peers. As a result, family members require treatment as well. FBT focuses on helping families learn to support teens with bulimia. Adults often struggle to understand the underlying causes of bulimia. This lack of understanding can lead to conflict or hostility within the home. FBT aims to mend these strained relationships while addressing the underlying causes of disordered eating. 

Medication

Various antidepressants can be used to treat bulimia. However, the only FDA-approved medication for bulimia treatment is Prozac (fluoxetine). It is a selective serotonin reuptake inhibitor that is used in combination with talk therapy to help teens overcome their fear of gaining weight. 

Teen Bulimia Treatment at Nexus Teen Academy

Nexus Teen Academy logo

Bulimia is a serious but treatable eating disorder. At Nexus Teen Academy, we offer compassionate care for teens with this condition. Our multidisciplinary team provides comprehensive treatment using evidence-based and holistic approaches. We also provide residential treatment that ensures your teen overcomes their fear of gaining weight. We teach them the importance of nutrition and a healthy weight to both teen girls and teen boys with eating disorders.

Our facility offers a safe and inclusive space where your teen will receive tailored care. We integrate medical, psychological, and peer-based support to ensure your teen overcomes challenges. If you would like to enroll your teen with bulimia in one of our programs, contact us today. 

Frequently Asked Questions (FAQs)

The main difference between anorexia and bulimia is that anorexia usually involves self-starvation. On the other hand, bulimia is characterized by binge-eating episodes that are immediately followed by purging. Some teens experience bulimic anorexia, which is characterized by infrequent binge-eating and purging episodes. 

Social media can contribute to the development of bulimia. It glamorizes certain body types and can be a haven for hateful comments. Cyberbullying and excessive social media use can cause your teen to develop body image issues, which often lead to disordered eating habits like bulimia. 

Yes, bulimia is fully treatable. However, some of its symptoms may take longer to go away.

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Executive Director Hannah Carr, LPC and nexus_admin