Bulimia Nervosa (for Teenagers)

What is bulimia?

Bulimia nervosa is an eating disorder. If you have bulimia nervosa, you eat larger amounts of food than most people would eat in a short time, then you may purge by making yourself vomit or using laxatives. Purging is meant to make up for binging. You may also cut back on eating or exercise too much to make up for binging.

Most bulimics have a normal weight, but you feel you lack control over your eating behavior. You often feel that your life is controlled by conflicts about eating. Some people with bulimia may swing back and forth between anorexia (a self-starvation eating disorder) and bulimia.

Although the disorder can affect men, most people with bulimia nervosa are young women.

How does it occur?

The exact cause of bulimia nervosa is not known. Some researchers believe that eating disorders may be related to problems with the chemicals in the brain that regulate mood and appetite.

If you have bulimia nervosa you may:

• have a family history of bulimia nervosa or eating disorders
• have a family or personal history of mood disorders, such as major depression, anxiety disorders, or bipolar disorder (manic depression).

What are the symptoms?

Signs and symptoms of bulimia include:

• eating large amounts of food in short periods of time without being able to stop
• making frequent trips to the bathroom after eating
• vomiting, or using laxatives, diuretics, or enemas to purge food
• strict dieting or fasting
• exercising a lot after eating
• repeated weight loss and gain of more than 10 pounds
• dehydration and electrolyte imbalance
• weakness
• depression and guilt after binge eating
• having heartburn or reflux from stomach acid injuring the esophagus or damaged teeth from stomach acid contained in vomit
• having swollen cheeks from repeated vomiting
• having scratches or scars on the back of fingers or hands from self-induced vomiting
• constantly thinking about being thin and feeling that weight is tied to self-esteem
• having menstrual problems.

Bulimia is especially dangerous when vomiting or laxatives are used to remove food from the body. Either habit can cause an electrolyte imbalance that can lead to irregular heartbeats and possibly heart failure and death.

How is it diagnosed?

Your health care provider takes a medical history and does a physical exam. He or she will ask about your eating patterns, looking for such behavior as:

• repeated episodes of binge eating followed by purging
• alternate binging and fasting
• secret eating and binging
• exercising excessively to prevent weight gain.

How is it treated?

If you have bulimia, you must recognize that you are suffering from a dangerous disorder. Treatment involves getting your eating habits back to normal. Your health care provider may recommend psychotherapy or family counseling. Psychotherapy, either individual or group therapy, is very important. You may also need medicine used for mood disorders, such as antidepressants or mood stabilizers.

How long will the effects last?

The risk of relapse exists for years after treatment ends.

How can I take care of myself?

• Eat well-balanced, nutritious meals.
• Schedule meals regularly, but not too rigidly. Avoid irregular eating habits and avoid fasting.
• Take vitamin and mineral supplements, if recommended by your health care provider.
• Avoid drinking too much caffeine.
• Do not drink alcohol.
• Avoid using laxatives and diuretics. These can have serious side effects if taken inappropriately.
• Seek professional help if you need to lose weight so you can lose weight slowly and to a healthy level.
• Exercise regularly and in moderation.

You may want to contact:

The National Mental Health Association (NMHA). NMHA's toll-free number is 800-969-NMHA. The Web site is http://www.NMHA.org.

Eating Disorders Awareness and Prevention, Inc. (EDAP). Their toll-free number is 800-931-2237. The Web site is http://www.nationaleatingdisorders.org