A parents’ guide to bulimia nervosa

Finding out that a child has an eating disorder like bulimia nervosa, or bulimia as it is usually known, can be a parent’s worst nightmare. It’s hard to know what to do and the myths surrounding the problem are frightening.

Bulimia nervosa, however, is not the end of the world. The more you find out about it, the more you will be able to help your child. Here’s what you need do know.

What is bulimia nervosa?

Bulimia nervosa is an eating disorder that is characterised by frequent bouts of binge eating followed by purging, either through self-induced vomiting, the use of laxatives or diuretics or, in some cases, excessive exercise. Bulimia sufferers are usually over-concerned about body image and therefore subject themselves to purging to rid the body of calories to avoid gaining weight.

Bulimia is most common among teenaged girls and young women. Males can also be affected, but in much lower numbers.

What causes bulimia is not fully understood. It is believed that several factors, individually or in combination, are involved. They include:

• Low self-esteem.
• Dissatisfaction with body image that is possibly exacerbated by the media promoting the notion that thin is beautiful.
• Traumatic experiences.
• Chemical imbalance in the brain.

Some are more susceptible than others to developing bulimia; genetics (other close family members suffering from eating disorders), a history of abuse and psychological problems all increase the risk.

The consequences of bulimia nervosa

Left untreated, bulimia can have serious health consequences. Possibly most obvious is deterioration of the teeth resulting from exposure to stomach acids (while vomiting) that destroy the enamel exposing the teeth to decay. The oesophagus, kidneys, heart and stomach can also be damaged while the menstrual cycle can be affected or stopped altogether.

Does your child have a problem?

Because bulimics don’t usually exhibit the extreme emaciation associated with other eating disorders like anorexia, it can be difficult to identify if your child has a problem. Sufferers also try to hide their behaviour but you may be able to spot these warning signs:

• Frequent complaints about weight or body shape and fear of putting on weight.
• Avoidance of eating with others.
• Visiting the bathroom during or straight after eating.
• A large number of sweet wrappers or a stock of snacks secreted in his or her room.
• Frequent and excessive exercise.
  Eating a great deal, especially sweet and high fat foods, at a single sitting.
• Deterioration in the appearance of the teeth.
• A change in behaviour – withdrawal, irritability.

What you should do

Early treatment is crucial for the best results and to prevent lasting damage, so you should seek advice as soon as possible. Your GP is the best place to start. But while professional help is indispensible, you have a vitally important role to play in the recovery process.

You should:

• Find out what you can about bulimia.
• Provide a happy, safe and secure home environment in which your child feels truly comfortable.
• Talk to your child about his or her problem without being judgemental. You should discuss treatment but avoid conversations about dieting, food and other people’s problems, especially weight problems.
• Expect some initial resistance from your child to discussing the problem.
  Eat healthily and keep regular meal times.
• Just be there for your child. Be a dependable friend, ready to offer unconditional love and support at all times.
• Be patient. Recovery is a long process and, particularly in the early stages, can be very frustrating and difficult.
• Try to become involved with local support groups and encourage your child to join in.
• Try to get your child to join in activities to keep her occupied. Family activities after meals are a good distraction from the desire to purge.

Your time, support and encouragement are the most important things you can give to your child.

Treatment for Bulimia Nervosa

Bulimia is usually treated using a therapeutic approach; cognitive behavioural therapy is the most common. In some cases, medication may also be necessary. The right home environment is important as hospitalisation is needed only in the most severe cases.