Causes of bulimia nervosa
There is no single cause of bulimia nervosa. But there are some factors that can put children and teenagers at higher risk for bulimia nervosa.
These risk factors include:
- low self-esteem
- concerns about weight and body image
- history of trauma or abuse
- being female
- having a family history of bulimia nervosa.
Signs and symptoms of bulimia nervosa
People with bulimia nervosa are often close to a normal body weight or even overweight. And it’s common for them to try to keep their condition a secret. This means that bulimia nervosa can be hard to spot.
General signs and symptoms of bulimia nervosa include:
- binge-eating or eating a larger amount of food than normal – you might notice food going missing
- purging after eating – this might include self-induced vomiting, over-exercising or taking laxatives
- having negative thoughts about body weight and body shape.
People with bulimia nervosa might also talk a lot about body weight and body shape, and always go to the toilet after meals. They often feel out of control, guilty and ashamed.
Physical signs and symptoms of bulimia nervosa include:
- swollen or puffy cheeks
- discoloured or damaged teeth or gums
- sores on the knuckles and back of hands
- frequent changes in weight (weight gain or weight loss)
- loss of or irregular menstrual periods.
The long-term consequences of bulimia nervosa can be severe and include:
- damage to the teeth, gums, mouth and oesophagus
- problems with the heart and kidneys
- a higher risk of suicide.
What to do if you notice the signs of bulimia nervosa
If you notice that your child has changed eating habits, mood and behaviour, particularly in relation to food, you need to talk with your child and a health professional as soon as you can.
It’s best to keep your conversations with your child calm and non-judgmental. Emphasise your concerns about your child’s health and wellbeing, not your child’s weight and appearance.
If you’re not sure how to talk with your child about these issues, you could first visit a doctor, dietitian or mental health professional and ask for help. Contacting a support organisation is another option.
Diagnosing bulimia nervosa
If your GP thinks your child might have bulimia nervosa, the GP will do a full physical examination. This might include things like a blood test, a urine test or an ECG. The GP will also talk with your child about eating behaviour, habits and thoughts.
The GP might then refer your child to a specialist service to confirm your child has bulimia nervosa and recommend appropriate treatment.
Treatments for bulimia nervosa
There is no single treatment that will work for all cases of bulimia nervosa. Treating bulimia nervosa requires a team of health professionals who have expertise in different areas.
Doctors will prescribe different treatment plans for different children, depending on age, the stage of the illness, the type and severity of the bulimia, the underlying causes and many other factors.
If your child has bulimia nervosa, he might need psychological therapy. This kind of therapy might include:
- one-on-one sessions with a psychologist or therapist
- group therapy – working with a group of people who also have eating disorders
- family therapy – having the whole family or part of the family come in and work with a psychologist or therapist. In fact, clinical guidelines say that parents and families should be included in treatment.
Selective serotonin reuptake inhibitors (SSRIs) are antidepressant medications that are sometimes used in the treatment of bulimia nervosa. The most commonly prescribed SSRI for bulimia nervosa is fluoxetine (Prozac).
Sometimes a child with an eating disorder needs to go to hospital, but this depends on the child’s weight, symptoms and other health issues. Your doctor will tell you if your child needs to go to hospital.
This can be a very worrying situation for you and your family, but your child might need to go to hospital to be treated for the physical effects of bulimia nervosa.
With treatment, people can recover from bulimia nervosa, but it’s also possible to relapse. If you notice that your child is showing the symptoms of bulimia again, see your doctor as soon as possible.