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Bulimia: Teen Version

What is bulimia?

Bulimia is an eating problem that causes you to binge, which means you eat large amounts of food in a short time without being able to stop. The amount of food you eat is much more than most people would eat at one time. You may then purge, which is getting rid of the food by making yourself vomit or using laxatives, water pills or enemas. You may also cut back on eating or exercise too much to make up for binging.

Most people with bulimia have a normal weight but feel they cannot control their eating. You may swing back and forth between anorexia and bulimia. Anorexia is an eating problem that causes you to be so afraid of becoming overweight that you eat as little as possible.

Although the disorder can affect men, most people with bulimia are young women. If you are pregnant, eating disorders can affect your health and your baby’s development.

What is the cause?

The exact cause of bulimia is not known. It may be related to problems with the chemicals in the brain that regulate mood and appetite.

You may be at risk of developing bulimia if you:

  • Have a family history of bulimia or other eating disorders
  • Have a family history of obesity
  • Have a family or personal history of depression, bipolar disorder, anxiety disorders, or obsessive-compulsive personality disorder
  • Have a history of physical or sexual abuse

What are the symptoms?

In addition to binging and purging, the signs and symptoms of bulimia include:

  • Strict dieting, trying fad diets, or going long periods without eating between binges
  • Ritualistic eating, such as never eating in front of other people
  • Exercising a lot after eating
  • Repeatedly losing or gaining more than 10 pounds
  • Having heartburn, throat pain, damaged teeth, or swollen cheeks caused by the stomach acid in your vomit
  • Having scratches or scars on the back of your hands caused by using your fingers in your throat to make yourself vomit
  • Feeling weak, depressed, or guilty after binge eating
  • Constantly thinking about being thin and feeling that your weight is tied to self-esteem

If you are a woman and you exercise a lot or your weight gets very low, you may not have monthly periods. Hormone changes result from low weight and low levels of body fat.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. He will ask about your eating habits and other behaviors.

How is it treated?

Bulimia does not go away or get better on its own. Treatment involves learning healthy eating habits. Your healthcare provider may suggest that you meet with a dietitian to create a healthy eating plan. You may need therapy to help you change how you think about yourself and food.

Cognitive behavior therapy (CBT) is a way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new thought and behavior patterns.

Your healthcare provider may prescribe medicine to help reduce constant thoughts about food. Medicines that help reduce depression and anxiety may help bulimia.

You may need to be hospitalized if your condition is severe and life threatening. Vomiting or using laxatives too often can cause an imbalance of minerals in your body that may lead to irregular heartbeats, heart failure, and death.

If you have bulimia, you may think constantly about eating for many years. You may need to continue treatment for many months. Being under a lot of stress can cause the symptoms to get worse. The earlier you seek treatment, the more successful it is likely to be.

How can I take care of myself?

  • Get support. Talk with family and friends. Join a support group in your area.
  • Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax, for example, take up a hobby, listen to music, watch movies, or take walks. Try deep breathing exercises when you feel stressed.
  • Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs. Do not overuse laxatives, diuretics, or diet pills. These can have serious effects on your health. Exercise according to your healthcare provider's instructions.
  • Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all of the medicines, natural remedies, vitamins, and other supplements that you take. Take your medicines as directed by your provider or therapist. Take mineral and vitamin supplements as recommended by your healthcare provider.
  • Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse. See your healthcare provider regularly to have your weight, blood pressure, heart rate, and temperature checked.

Get emergency care if you or a loved one has serious thoughts of suicide or harming others.

What can be done to help prevent bulimia?

  • Learn all you can about bulimia. Don’t let what you see online, on TV, or in magazines affect your self-esteem. Question advertisements or articles that make you feel bad about your body shape or size. Are they are trying to sell you something? Is what they say and show true? Or, have the pictures been air-brushed or computer generated to make the person look so perfect?
  • Remember to eat a variety of foods in healthy amounts. No single food is always bad or always good.
  • Try to accept your body’s unique shape and size. It is much more important to be healthy than to be skinny.
  • Learn to appreciate yourself for who you are, not what you look like, or what you weigh. Treat yourself with respect. Choose to value yourself based on goals, accomplishments, talents, and character.
  • If you think someone has an eating disorder, talk with them. Gently but firmly encourage the person to seek professional help.

For more information, contact:

Developed by RelayHealth.
Pediatric Advisor 2015.2 published by RelayHealth.
Last modified: 2015-03-13
Last reviewed: 2014-01-08
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.
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