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Bulimia nervosa, like all eating disorders, is a complex combination of physical, emotional and mental factors that do not look the same in every person. That being said, there are some general guidelines displayed in order to be formally diagnosed with bulimia nervosa according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Residential or bulimia inpatient treatment is often the ideal method of addressing this disorder.

Typical Bulimia Nervosa Symptoms

Often shortened simply to “bulimia”, bulimia nervosa is comprised of a set of symptoms that center around binge eating substantial amounts of food followed by some method of purging. These foods are often those that are filled with empty calories and the teen girl or young woman feels powerless to stop herself from eating large amounts of them. This binge eating is followed by a crushing sense of guilt and shame. Horrified at what she has done and the potential side effects that it could have on her weight and figure, she then purges her body in an attempt to get rid of the excessive calories she consumed.

Some typical methods include making themselves vomit and/or misusing products such as enemas, weight loss supplements, laxatives or diuretics. Some people who have bulimia nervosa do not rely on artificial means to purge though. Instead, they may follow a plan of strict dieting, engage in excessive exercise or fast in an effort to get rid of the calories they binged on and to prevent themselves from gaining any weight.

What’s Underneath Bulimia Nervosa? 

Friends, family members, coworkers, coaches and other people who are close to someone who has bulimia nervosa might notice some of the physical signs of the condition such as not allowing herself to eat very much, skipping meals and exercising excessively. In spite of that, even those people who are closest to them often do not realize that she has bulimia eating disorder.

Not only can this delay be the result of the young woman not addressing the true seriousness of her actions on her physical well-being, but it can also be due to those thoughts that she might not be sharing with others. For example, she may be thinking her body’s weight, shape and size are not the way that she wants them to be and that by purging herself she can help alleviate her fear of gaining weight. She may feel like she is out of control when she binges on food and then regains her sense of control by getting rid of the calories from her body. She also may not understand the potential for long-term effects on her body and her mind if she continues her cycles of binge eating and purging or she may not realize there are such side effects.

Not Realizing She Has a Problem

Young people receive so many messages from the media regarding their body shape, size and weight. While a person’s first thought may be that these messages are highlighting the perception that “thin is better”, the reality goes deeper than that.

It is a fact that obesity is a serious issue, especially in the United States, though other countries are beginning to see its effects as well. Not only is there a noticeable bias against those individuals who are overweight, but there are very real health issues associated with the issue. Many young women and teen girls may see their actions as very severed ways to prevent obesity and its related side effects that include significant, and often deadly, chronic diseases. For example, childhood-onset diabetes is on the rise in the United States and can set the child up for a lifetime of medication and chronic disease maintenance.

Bulimia Residential Treatment: The Hows and Whys

Perhaps because she cannot see the effects of her actions beyond the fact that she is controlling her weight, a young woman or teen girl may not be aware of the side effects that binging and purging have on her body. For example, severe gum disease and/or tooth decay, digestive problems and esophagus issues due to stomach acids being introduced are all potential health problems that become more likely to occur when a young woman or teen has bulimia.

Dehydration, a condition that is often not easy for the person who has it to realize, can occur as a result of purging. Left untreated, dehydration could lead to more serious medical conditions that might even be life-threatening, such as kidney failure.

Of course, physical problems are not the only concern when it comes to eating disorders. Suicidal thoughts, personality disorders, negative self-esteem and the misuse of drugs and/or alcohol are all additional complications that can occur as the result of an eating disorder, such as bulimia nervosa.

This combination of physical, mental and emotional issues can make an informal diagnosis by family members, friends and other loved ones complicated. Indeed, a young woman or teen girl who displays the above behaviors should be carefully observed if there is a question of whether or not she has bulimia eating disorder. For further guidance, seek out a consultation with her physician or other trusted medical professional.

Treatment for Anorexia and Bulimia

Because many young women and teen girls have a difficult time recognizing their behavior is harmful, treatment for anorexia and bulimia often must extend beyond the capabilities of their primary care physician. This medical professional, however, is a good resource that can help parents, friends and other loved ones decide if there is an issue and which steps are the best ones to take. For example, if there is a question about whether or not a person has bulimia eating disorder, this medical professional can identify the early signs of a possible eating disorder and help prevent its development or recommend actions to stop it from advancing further.

Can an Eating Disorder be Prevented? 

One thing commonly seen in those who are closest to a teen girl or young woman who has an eating disorder is that they blame themselves. They may wonder if their loved one’s eating disorder could have been prevented and if they could have done something to prevent it.

Supportive relationships with those people who foster a positive body image in themselves and those around them is a good step in buffering against the development of an eating disorder. Avoiding talk of weight, dieting and other related issues is another way to help guard against the development of eating disorders. Making family meals a regular part of life and focusing on enjoying them and the company at the table can also help.

It is important to remember, though, that even if the family, friends, and others in a person’s life do everything right, if she later develops an eating disorder, it does not mean they are to blame. For example, some people who have a close relative such as a parent, child and/or sibling who has an eating disorder they may be more likely to develop one themselves. Teen girls and young women who have emotional, psychological and/or mental health symptoms, such as anxiety disorders, depression, personality disorders or substance use disorders could be more prone to also developing an eating disorder. These disorders are closely linked with bulimia nervosa and other eating disorders.

A teen girl or young adult who places a great deal of emphasis on dieting could find it very easy to veer into the realm of eating disorders without realizing that she has done so or without intending to do so. Binge eating can be triggered by a certain kind of food, stress in the person’s life, boredom, a poor self-image of her body or a combination of these factors.

Is Bulimia Treatment Near You the Best Choice?

When looking for bulimia inpatient treatment, there are several factors to consider. While looking at the philosophy of the treatment center, their accommodations and programs are all important things to think about, it is also a good idea to consider whether a bulimia treatment near you is the best option.

There are usually two trains of thought to think about when considering this question. The first one centers around the support of family, friends and other loved ones of the person who is going to be entering bulimia inpatient treatment. For many clients, their support network is an important and vital part of their recovery. In addition, involving this support network can mean that it obtains the education and resources needed to help the young woman or teen girl during her recovery.

The other school of thought that often drives the thought process of deciding whether to seek bulimia treatment near them is that some young women and teen girls have a fuller recovery if they are completely removed from their present environment. This can often be difficult for family members, friends and others who are close to her to understand without their feeling being hurt. However, it is important to remember this decision is not a reflection on those people who are close to the individual with a bulimia eating disorder. Instead, it is focused solely on the method that is best at helping her attain her healthy self and recover fully.

While consulting with a physician can provide valuable insight into their loved one’s condition for family members and friends, it is important to remember that the final decision for treatment is theirs alone. A more structured and supportive treatment environment in the form of bulimia inpatient treatment is often the best choice for young women and teen girls who are in any stage of their bulimia eating disorder. At Clementine, our sole focus on the unique needs of young women and teen girls means that our programming is developed with them in mind. Staffed by supportive and compassionate professionals who have a vested connection in the treatment of eating disorders means they offer an element of treatment that others cannot match. When combined with our luxurious accommodations and comprehensive treatment plans, it’s easy to see why Clementine is the choice so many families make for their loved ones.





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.