Teen Eating Disorders
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What is Bulimia Nervosa?

Bulimia nervosa is a serious eating disorder that can be fatal if left untreated. People who have bulimia nervosa routinely "binge," consuming large amounts of food in a very short period of time, and immediately "purge," ridding their bodies of the just-eaten food by self-inducing vomiting, taking enemas, or abusing laxatives or other medications. If left untreated, bulimia nervosa can lead to serious and even life-threatening problems, such as depression, anxiety disorders, heart damage, kidney damage, injury to all parts of the digestive system, and severe dental damage. Those with bulimia nervosa are at risk for dangerous impulsive, self-destructive behaviors, such as kleptomania, self-mutilation, alcohol and/or drug abuse, and sexual promiscuity.

Bulimia nervosa typically begins during adolescence, and while it most often occurs in women, it also affects men. Individuals with the disorder usually feel acutely out of control during both their bingeing and the purging episodes and afterwards suffer from intense feelings of shame, guilt and self-loathing. Embarrassed by their behavior, they typically "binge and purge" in secret and are often successful in hiding their problem from others. Even family members and close friends may have difficulty detecting bulimia nervosa in someone they know.


  • Obsessive preoccupation with food.
  • Excessive concern about body shape and weight.
  • Episodes of bingeing, consuming excessively large amounts of food in a short period of time (usually within two hours).
  • Episodes of purging to immediately get rid of just-consumed food using self-induced vomiting, taking enemas, or abusing laxatives or other medication.
  • Binge/purge behavior at least twice a week for a period of three months or longer.
  • Excessive exercise, often accompanying periods of fasting to counteract or prepare for binge episodes.
  • Disparaging self-criticism; depressed mood; feelings of shame and guilt during and after bingeing and purging episodes.

Although bingeing and purging usually occurs in secrecy or as inconspicuously as possible, the signs that a person has bulimia nervosa eventually become detectable. Warning signs include:

  • Abdominal pain and bloating.
  • Irregular menstrual cycle.
  • Constipation.
  • Swollen "chipmunk cheeks."
  • Dental erosion and decay.
  • Overall weakness.
  • Swelling (edema).
  • Swollen salivary glands.
  • Callouses and scabs on the back of the hand from constantly scraping them against their teeth while inducing vomiting.


While an exact cause or causes are yet unknown, bulimia nervosa is likely brought on by a complex interplay of factors which can include emotional and personality disorders, family stress, possible genetic or biologic susceptibilities, and a culture that is obsessed with body image and thinness.


The first course of action should be to seek help from a physician to diagnose and treat any physical problems. To treat the symptoms of bulimia nervosa, people often benefit significantly from therapy. There are therapists who are especially experienced at helping people who have eating disorders. Therapy provides a safe, comforting, and confidential setting in which to receive the kind of help that can best determine and treat any underlying emotional and psychological causes for the disturbed eating. behavior, as well as address the effect it has had on their sense of self, their relationships with others, and their capacity to function optimally in everyday life.

Both Anorexia and Bulimia...

There are many similarities in both illnesses, the most common being the cause. There seems to be a common occurence of sexual and/or physical and emotional abuse in direct relation to eating disorders (though not all people living with Eating Disorders are survivors of abuse). There also seems to be a direct connection in some people to clinical Depression. The eating disorder sometimes causes the depression or the depression can lead to the eating disorder. All in all, eating disorders are very complex emotional issues -- Though they may seem to be nothing more than a dangerously obsessive weight concern on the surface, for most men and women suffering with an eating disorder there are deeper emotional conflicts to be resolved.

"...the only blame I cast is on myself... for wanting the happiness I couldn't have... and still now, can't believe I deserve..."

Diagnostic Criteria

The following is considered the "text book" definition of Anorexia Nervosa to assist doctors in making a clinical diagnosis... it is in no way representative of what a sufferer feels or experiences in living with the illness. It is important to note that you can still suffer from Anorexia even if one of the below signs is not present (also see the Signs and Symptoms section). In other words, if you think you have Anorexia, it's dangerous to read the diagnostic criteria and think "I don't have one of the symptoms, so I must not be Anorexic".

  1. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).
  2. Intense fear of gaining weight or becoming fat, even though underweight.
  3. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
  4. In postmenarcheal females (women who have not yet gone through menopause), amenorrhea (the absence of at least three consecutive menstrual cycles).
  • Restricting Type: during the current episode of Anorexia Nervosa, the person has not regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)
  • Binge-Eating Type or Purging Type: during the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating OR purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)

"...the reflection staring back at me is not what you see... my guilt running the need to destroy my duration... forcing me to seek guidance on an empty plate of stolen dreams and fractured rainbows..."