Warning Signs Your Teen May Be Bulimic
The condition, also known as bulimia nervosa, is marked by binge eating, which entails consuming large amounts of food in short periods of time, and purging, which involves eliminating the food (or the excess calories) from the body by self-induced vomiting, laxatives, or excessive exercise. Bulimia typically starts during adolescence or young adulthood. While it’s often considered a condition that affects females, it can affect males as well. About 10 percent to 15 percent of bulimics are believed to be male.
Bulimia nervosa is a complex condition likely caused by a combination of factors. A teen’s risk is often higher if a close relative has the eating disorder. In addition, it’s believed that certain personality traits, like the need for perfectionism, contribute to its development in some cases. Social factors, such as peer pressure or cultural ideals about beauty and body shape, are typically involved as well. The condition can emerge at any time; however, some cases are triggered by significant stressful events, such as one’s parents getting a divorce or leaving home to start college.
Signs of Bulimia in Teens
Eating in secret -- It’s common for those struggling with bulimia to eat (and especially binge) in secret. They may visit the kitchen in the middle of the night or make an excuse to drive to a fast food restaurant alone. A bulimic teen may be quick to offer to clean the kitchen after a meal, shooing everyone else away so he or she can devour leftovers and scraps. Some teens try to hide the fact that they’re eating so much by replacing the food they’ve consumed. For example, they might consume an entire box of chocolate chip cookies and then replace it with a new one. Bulimic teens may also cover up eating binges by hiding any evidence, such as food wrappers, containers, or boxes.
Hoarding food -- In addition to eating in secret, some adolescents with bulimia will hoard food. This allows them to binge when no one else is around. They may also resort to stashing food in their bedroom, purse, gym bag, locker or car.
Self-induced vomiting -- A bulimic adolescent will often self-induce vomiting in the privacy of the bathroom. However, in serious cases, he or she will throw up the food into whatever is available, whether it’s a bowl hidden under a bed or a plastic shopping bag in the car. Self-induced vomiting is always done in secret, but it can still leave physical telltale signs. Your teen is likely purging if he or she:
• Smells like vomit upon returning from the bathroom
• Covers the odor of vomit with excessive use of mouthwash, mints or air fresheners
• Has scrapes, calluses, or scars on the backs of hands or fingers
• Frequently sounds hoarse or has a persistent sore throat
• Experiences swollen, chipmunk-like cheeks
• Has discolored teeth (which may look ragged or yellow) or tooth decay
• Possesses ipecac syrup (which induces vomiting)
Using laxatives or diuretics -- The act of purging isn’t limited to self-induced vomiting. Some teenagers will use laxatives to induce bowel movements. Diuretics can also be used to increase urine output in the belief that it will lower body weight. Although it’s less common, some teens will use enemas to rid the body of food.
Using diet aids -- Teens with bulimia may purge by using diet pills excessively after a binge. In one study of patients suffering from bulimia, nearly 20% reported taking diet pills regularly for more than one year.
Exercising excessively after eating -- A bulimic adolescent may work out vigorously, especially after an episode of binge eating, in order to burn off extra calories. Sometimes this is done in combination with self-induced vomiting. However, some teens will regularly use excessive exercise instead of self-induced vomiting to rid themselves of the calories they’ve consumed.
Eating large quantities of food without gaining weight -- Teens generally have a reputation for having higher metabolisms than adults. However, if they are consuming large quantities of food, consistently, without gaining weight, that may be a warning sign of bulimia.
Viewing themselves as overweight when they’re not -- Bulimia is much more about self-perception than food. Bulimics often perceive themselves as overweight, even when they’re at a healthy weight or are underweight. Teens with bulimia often express severe and persistent dissatisfaction with their body’s shape or weight. It’s not uncommon for a bulimic adolescent to constantly compare his or her own body with those of celebrities (who often convey an unrealistic ideal) or elite athletes.
Experiencing depression -- It’s very common for depression to be present when there’s an eating disorder. Be alert for prolonged periods of sadness, listlessness, or hopelessness. If your teen becomes preoccupied with death or suicide, or starts to give away treasured belongings, seek immediate medical attention.
Irregular menstrual cycles -- The malnutrition that often occurs with bulimia can lead to hormonal fluctuations that cause menstrual periods to become irregular or cease. Girls with bulimia who purge by vomiting at least once a week are three times more likely to experience irregular periods.
Serious medical problems -- Sometimes, the first indication of bulimia is the appearance of an illness or condition that requires medical attention. Constant cycles of bingeing and purging can result in a ruptured esophagus or stomach, irregular heartbeat, or kidney problems.
Treatment for Bulimia
Bulimia nervosa rarely goes away on its own, and you shouldn’t assume that it’s just a phase and your teen will “grow out of it.” It’s often a chronic condition. Even when it’s under control, the physical side effects can last for years. It’s critical to seek professional help as soon as possible if you suspect your teen is struggling with bulimia. Early treatment will minimize its significant physical effects. In addition, the longer bulimia persists without treatment, the more difficult it is to reverse the behaviors. Contact an eating disorder recovery treatment program or ask your teen’s pediatrician for a reference. Don’t wait to reach out for help.