What is bulimia nervosa?
Bulimia nervosa is an eating disorder in which a child has abnormal or unhealthy eating habits, often due to desire for a certain appearance or body type. With this disorder, a child will eat large amounts of food at once and will feel as if they don’t have the control to stop (binge eating). They will then self-induce throwing up (purging) to avoid gaining weight. They may also try to control their weight by using laxatives, diuretics, weight loss pills, exercising or fasting.
Who is at risk?
Any child can be affected by bulimia. It is more common in girls and usually begins between ages 10-15. Many factors play a role in a child becoming bulimic such as genetics, stress, and pressures to have a particular appearance or weight. Children with low self-esteem, weight concerns, or those with anxious or depressive systems are at a higher risk for developing bulimia.
What are the symptoms of bulimia nervosa in a child?
Many children with bulimia are a normal weight for their height, so it can often go unnoticed. Main features include:
- Binge eating at least once a week for three months
- Feeling out of control, ashamed, guilty, or afraid after binge eating
- Purging or exercising after eating to avoid weight gain
- Judging themselves based on their body shape and weight
Additional red flags that may indicate bulimia nervosa include:
- Anxiety about eating meals in public
- Stealing or hiding food
- Constant talk about their weight or food
- Spending excessive time in the restroom, especially after meals
- Consuming large amounts of food at once
- Constantly exercising
- Depression or isolation
How is bulimia nervosa diagnosed in a child?
There is no medical test used to diagnose bulimia nervosa, but there are many clues that help doctors and nurses identify children with bulimia. Most information is obtained by talking to the child or parents about the child’s eating habits, behaviors, and thoughts.
Many children with bulimia nervosa present with a history of tooth or gum decay, sore throat, swollen salivary glands, dizziness/weakness, abdominal pain, or calluses on the fingers or knuckles due to induced vomiting.
There are also tests that doctors or nurses use to help assess other areas of the child’s health, since bulimia nervosa can lead to many additional health problems. These tests include blood tests, urine tests, or an electrocardiogram (which assesses a child’s heart).
What are possible complications of bulimia nervosa in a child?
Bulimia nervosa can cause many health problems including:
- Dehydration
- Feeling tired
- Stomach pain, bloating, and constipation
- Damage to the esophagus
- Damage to teeth, gums, or cheeks
- Irregular menstrual periods
- Problems with heart, kidneys, or glands
How is bulimia nervosa treated in a child?
Treatment for bulimia nervosa includes:
- Psychotherapy which involves the child meeting with a therapist to talk about their feelings, thoughts, and life and how that has affected their body image and eating habits. This can be done with individualized sessions, or with a group or the family.
- Use of medications such as antidepressants
- A healthy eating plan
- Dental care for damaged gums and teeth
- When should I call my child’s healthcare provider?
Call us at (417) 882-1600 if your child’s weight changes dramatically (losing or gaining), if your child’s cheeks or glands swell, if you notice tremors, extreme thirst or cold, or if your child demonstrates the signs mentioned above.
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Hannah Peck University of Missouri School of Medicine Class of 2023