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Bulimia nervosa is a serious and pervasive disorder that rarely resolves on its own. When left untreated, bulimia nervosa can lead to grave consequences. For this reason, it is essential for anyone who has symptoms of this disorder to be evaluated and treated properly as soon as possible. 

As a parent, it is natural to watch your child for signs of serious disorders like bulimia nervosa. If you suspect that your child may have this illness, it is important to take action immediately. Below is some information to help you determine whether your child may have bulimia nervosa, as well as to formulate a plan for dealing with this issue. 

Understanding Bulimia Nervosa 

Before you can determine whether your child may be struggling with bulimia nervosa you need to have some basic knowledge of this illness and what it usually looks like. In its simplest form, bulimia nervosa is a disorder that involves a cycle of binging and purging. During the binge phase, the individual eats a large amount of food at one time. In most cases, the individual will feel “out of control” while binge eating. During the purge phase, the individual uses extreme methods to purge the excess calories from the body. Purging behaviors may include induced vomiting, the use of laxatives and/or excessive exercise. The cycle of binging and purging is detrimental to the individual’s health, both mentally and physically. 

Most people who have bulimia nervosa will be excessively preoccupied with their body shape and/or weight. Bulimia nervosa tends to co-occur with body dysmorphic disorder, which is a mental condition that causes people to see themselves in an unreasonably negative way, often with imagined or exaggerated flaws. People with bulimia nervosa tend to judge themselves very harshly at all times, regardless of the opinions of family and friends. 

If left untreated, bulimia nervosa can lead to serious complications. Some of the possible complications of this disorder include:

  • Tooth decay and gum disease usually caused by repeated vomiting. 
  • Dehydration from vomiting and/or misuse of laxatives. 
  • Heart problems. 
  • Problems with the digestive system. 
  • Disruptions in the menstrual cycle. 

Bulimia nervosa can have psychological consequences as well, including low self-esteem, poor social functioning, relationship problems, anxiety, depression and even the development of personality disorders. Some people with bulimia nervosa may also develop addictions to drugs or alcohol, engage in self-injury and/or become suicidal. In the worst cases, someone with bulimia nervosa can die from one or more of these complications. For this reason, it is important to seek treatments for a child with bulimia nervosa as soon as you see signs of the disorder. The longer the disorder continues without professional treatment, the harder it will be for your child to overcome. 

How to Recognize Bulimia Nervosa

As a parent, you may be able to recognize the signs of bulimia nervosa in your child if you pay close attention to their habits. Some of the signs to look for in your child include:

  • An unreasonable preoccupation with weight or the appearance of the body. 
  • A negative, unrealistic body image. 
  • Episodes of eating large amounts of food at one time. In many cases, these episodes will include foods the individual might avoid normally. 
  • Disappearing to the bathroom during meals or right after eating. 
  • Engaging in excessive amounts of exercise, strict diets and/or fasting after episodes of binging. 
  • Fluctuating weight. 
  • In people who vomit, damaged teeth or gums may appear. People who repeatedly induce vomiting may also develop sores or calluses on their hands. 
  • Swelling in the face, cheeks, hands and/or feet. 
  • Avoiding eating in front of other people.

If you notice any of the signs above, your child may be struggling with bulimia nervosa, and it is time to take action. Keep in mind that your child may not be losing weight or underweight even if they have bulimia nervosa. In fact, many people who struggle with bulimia nervosa are a normal weight or even heavier than normal. Even if your child does not appear to be losing weight, you should still investigate the situation if you notice signs of this eating disorder. It is also important to note that someone with bulimia nervosa will not necessarily display all of the symptoms listed above. As a parent, it is important to trust your instincts if you see signs of a problem.

What to Do Next

If, after watching your child, you believe that bulimia nervosa may be an issue, you need to take action to protect their future. Follow the steps below to give your child the best chance of making a full recovery. 

1. Learn as much as you can about the disorder. 

If you think your child has bulimia nervosa, the first thing you need to do is learn about the disorder and its causes so you can understand your child’s situation better before you approach them. You can find relevant information about bulimia nervosa from trusted sources online or by contacting an eating disorder treatment center. In many cases, these facilities offer support specifically for the family members of people struggling with bulimia nervosa. 

2. Research different treatment options. 

Before you approach your child to discuss the existence of an eating disorder, it is best to have a treatment plan ready in hopes that the child will be willing to enroll. Be sure to compare all of the different treatment programs available to find the option that will be most effective for your child. Keep in mind that treatment programs vary considerably. Some of the factors to consider as you compare different treatment options include:

  • The focus of the treatment. – In general, it is best to choose a facility that offers programs focused specifically on bulimia nervosa. Also, because you are seeking treatment for a child or adolescent, it is best to select a program designed specifically for people in this age group.
  • The reputation of the facility. – Always do your best to choose a treatment facility that has a solid reputation of providing effective services to patients. You can learn about different facility’s reputations by reading reviews and testimonials online, as well as by talking to patients or family members of patients who have completed programs at that facility. 
  • Customization levels. – The best bulimia nervosa treatment programs will customize their treatment plans according to the background and characteristics of your child. If possible, choose a program that offers a high level of customization so you can be sure your child is getting the best possible quality of treatment. 
  • Success rates. – Perhaps one of the most important factors to consider as you compare different treatment plans is the success rate of the program. Inquire about success rates from all prospective treatment programs and ask for documentation if possible. 
  • Affordability. – Although the cost of your child’s treatment program should not be the deciding factor, most parents will also need to consider affordability for budgetary purposes. Keep in mind that, if your child is covered by health insurance, your out-of-pocket expenses for eating disorder treatment may be lower. 

3. Have an open and honest conversation with your child. 

Your child may already be aware that a problem exists, or the child may be in denial. The next step in the process of helping your child involves sitting down to have a conversation about the signs you have seen and the possibility of bulimia nervosa. If your child is receptive to the idea of a bulimia nervosa diagnosis, the path forward will be easier. However, do not be surprised if your child denies the existence of a problem, especially at first. Your child may even express anger or rage when confronted with this issue. Try not to take any of your child’s words or actions personally at this time. 

4. Don’t be confrontational. 

While it is important to be open and honest when discussing the issue if bulimia nervosa with your child, being angry or directly confrontational is not recommended. Approach your child in a compassionate, non-judgmental way, assuring them that you will provide your unconditional love and support no matter what.  

5. Schedule an appointment with treatment specialists. 

Do your best to set up an appointment with treatment specialists so your child can be properly evaluated. Encourage your child to actively participate in the process of reviewing treatment programs and making a decision. When your child is involved in the decision-making process, resistance to treatment may be lower. 

6. Seek support for yourself. 

Life as the parent of a child with bulimia nervosa can be incredibly challenging. In many cases, parents feel directly responsible for their child’s disorder and may deal with a range of related emotions, including guilt and shame. Parents of children with eating disorders often face anxiety as well, especially when children are still going through treatment. Fortunately, support specifically for parents of children with eating disorders is available. Take advantage of these opportunities for yourself. If you have other children, consider seeking support for them as well. 

Bulimia Nervosa Treatment at Clementine

Clementine is an affiliate of Monte Nido, a well-respected network of eating disorder treatment facilities. At Clementine, we serve adolescents exclusively. We understand that adolescents experience eating disorders in a uniquely, and all of our programs are tailored specifically to members of this age group.

At our facility, we believe that eating disorders like bulimia nervosa are complex and arise from several different factors. All of our programs are customized to meet the needs of each patient, based on the patient’s background and the nature of their specific experience with bulimia nervosa. We offer a combination of medical and psychiatric care to give patients the best chance of making a full recovery from bulimia nervosa.

If you choose to enroll your child in bulimia nervosa treatment at Monte Nido, the process will begin with pre-admission evaluations. During this part of treatment, our team will review all of your child’s mental health and medical information to devise the most appropriate treatment plan. Our treatment program is based on a system of levels. Your child begins at the entry level and will progress until they reach level four. The goal of this specialized treatment process is not only to change your child’s behavior concerning food, but also to help the child understand why bulimia nervosa developed so they can avoid falling into the same patterns after treatment is complete. Also, your child will learn important skills to help them outside the facility, including skills related to meal planning, coping with stress and dealing with triggers. Furthermore, we offer supportive services for family members, such as multi-family support groups, family therapy and parent education programs.

If you think your child may be struggling with bulimia nervosa or another eating disorder, you need to seek professional help as soon as possible. Please contact Clementine today to learn more about our programs or to set up an appointment. 


Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.