A teen with bulimia will binge (eat a lot of food in a short amount of time), and then either purge (expel it using laxatives, diuretics, or by making themselves vomit) or otherwise “make up” for their binge (e. g. by fasting or exercising), which doesn’t usually drastically affect their weight. A teen with anorexia will restrict their food intake and eat extremely small amounts of food (or only eat certain foods), resulting in rapid weight loss. [3] X Trustworthy Source National Institute of Mental Health Informational website from U. S. government focused on the understanding and treatment of mental illness. Go to source Don’t mistake bulimia for binge eating disorder; they both involve eating large quantities of food, but those with binge eating disorder don’t do anything to make up for it, which results in weight gain. [4] X Trustworthy Source MedlinePlus Collection of medical information sourced from the US National Library of Medicine Go to source It’s possible for a teen to have binge-purge anorexia, where they frequently restrict calorie intake and purge what they do eat, or an unspecified eating disorder. Their doctor can make the distinctions.
Your teen may eat less or the same amount of food around you, but eat much more when you aren’t around, or binge when everyone in the house is asleep. If your teen is hoarding food or food is going missing from the kitchen, your teen may be using it for their binges. They may even take food that they aren’t supposed to eat. If your teen is drinking a lot of water before or after they eat, they may be planning on purging; drinking a lot of water is known to make it easier to vomit. [6] X Research source Most people struggling with bulimia feel they have no control over their binges, so they’ll try to keep them secret - meaning you’re unlikely to see your teen binging when you’re around.
If you discover your teen has been using syrup of ipecac to make themselves vomit, take away the ipecac and seek medical attention as soon as possible; frequent use of ipecac has been associated with heart problems that can be deadly. [8] X Trustworthy Source PubMed Central Journal archive from the U. S. National Institutes of Health Go to source [9] X Trustworthy Source PubMed Central Journal archive from the U. S. National Institutes of Health Go to source
The bathroom may smell of vomit, and the person themselves may even smell like vomit after leaving the bathroom. [12] X Trustworthy Source HelpGuide Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources. Go to source On the flip side, if there’s frequently air freshener used when it wasn’t used before and your teen smells like they brushed their teeth, they may be trying to cover up the smell. [13] X Research source If your teen flushes the toilet multiple times and the toilet isn’t known to be faulty, it’s possible they may be purging; sometimes all of a purge can’t be flushed down the first time. Clogged drains may also be a sign of vomiting; some teens with bulimia will purge in the shower or the sink to avoid detection or having to flush the toilet. If your teen was never one to clean their bathroom, but has suddenly taken up the habit of cleaning (and frequently cleans the toilet or drains), they may be trying to hide their purges.
Swollen cheeks (caused by the swelling of the saliva glands) Reddened knuckles with scrapes or calluses (caused by sticking the fingers down the throat) Teeth discoloration (due to frequent vomiting) Dehydration (due to frequent vomiting, or overuse of laxatives and/or diuretics) Reddened eyes (due to burst blood vessels caused by vomiting) Chapped or dry lips (from either dehydration or frequent vomiting) Sore throat (from frequent vomiting) Raspy voice[15] X Research source
Those who exercise excessively will often pick exercises that burn the most calories, such as aerobic exercises or running. [17] X Trustworthy Source HelpGuide Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources. Go to source Common excuses for not eating include “I’m just not really hungry”, “I ate a big meal at lunch”, “I don’t like that food”, “I’m on a diet”, “I’m really busy tonight”, or “I’m not feeling well”. [18] X Trustworthy Source HelpGuide Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources. Go to source
Large quantities of food boxes or wrappers, especially ones that you don’t remember buying or ones that are found in your teen’s room, may be a sign of binging. [19] X Trustworthy Source National Eating Disorders Association Nonprofit organization dedicated to supporting individuals and communities affected by eating disorders Go to source Empty medication bottles can also signal a problem if they’re for things like laxatives, diuretics, or diet pills. [20] X Trustworthy Source National Eating Disorders Association Nonprofit organization dedicated to supporting individuals and communities affected by eating disorders Go to source
Remember that teens often have very irregular periods at first; having an irregular period or missing periods can be normal for a younger teen if they haven’t been menstruating for long. It should only be cause for concern if their periods were regular, but became irregular or ceased. A missed period can be caused by a variety of factors, which can range from weight changes to a reproductive health issue to pregnancy; this isn’t a foolproof way of figuring it out.
Talking a lot about weight, weight loss techniques, calories, exercise, or how much they’ve eaten Researching weight loss - such as by reading magazines, websites, or books with diet tips Being extremely interested in fad diets, calorie counting, or other weight-loss regimes Spending time on websites and forums that encourage weight loss, healthy or unhealthy, and share tips about it - especially if the sites are labeled as “pro-ana” or “pro-mia”[24] X Trustworthy Source Michigan Medicine The University of Michigan’s medical center, which provides patient care, supports research, and educates the public on health topics Go to source
Not everyone who withdraws has an eating disorder; withdrawal can be a sign of many other issues, ranging from abuse to depression.
Your teen may deny that anything is wrong, or insist that they’re fine when questioned.
If food goes missing from the house every time your teen is struggling with negative emotions, or you notice signs of them purging, exercising excessively, or food-restricting, it’s possible they may have an eating disorder (whether or not it’s bulimia). It’s common for someone with an eating disorder to have a comorbid mental health disorder, such as depression or anxiety.
Wearing baggy clothing Spending more time than normal to get dressed Frequently checking themselves in the mirror Complaining about feeling unattractive Being overly concerned about their weight or shape Having a very negative view of their body or appearance Reacting strongly to comments about their weight[31] X Research source
Self-criticism (which may or may not be related to their weight) Feeling like their worth is dependent on their weight or on others’ perception of them Refusal to make eye contact or be touched Rejecting praise or compliments Negative thought tracks (e. g. “I’m too stupid to pass that advanced class, so why bother?” or “It’s no use, nothing is ever going to get better”) Self-harm and/or suicidal thoughts - if you notice these, seek immediate help
Be careful not to say anything about their looks, whether positive or negative. [35] X Research source Eating disorders don’t always have to do with looks, and even when they do, a well-intended comment can backfire and upset your teen. Keep in mind that your teen may not want to be helped. You can’t force them to want help - all you can do is encourage them and wait for them to want to accept it.
Be careful not to say anything about their looks, whether positive or negative. [35] X Research source Eating disorders don’t always have to do with looks, and even when they do, a well-intended comment can backfire and upset your teen. Keep in mind that your teen may not want to be helped. You can’t force them to want help - all you can do is encourage them and wait for them to want to accept it.
Therapy Support groups Medication - whether to treat bulimia or a comorbid condition such as depression Inpatient treatment or hospitalization, in severe cases
Engage your teen in meal preparation to help them build a positive relationship with food. Family bonding can help a vulnerable teen feel more secure. Stow away or get rid of media (such as magazines and TV show subscriptions) that promote dieting and weight loss or show unrealistic body expectations, and consider restricting websites that encourage this as well - although keep in mind that this may upset or frustrate your teen. [39] X Research source Try not to binge on foods when you’re upset, and don’t offer food to your teen as a source of comfort. This can set a bad example and/or cause a binge-purge cycle.
Praise them for things that don’t have to do with their appearance or weight, such as extracurriculars or hobbies. [40] X Trustworthy Source HelpGuide Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources. Go to source
Your teen can’t “just stop” having bulimia - many sufferers feel they have minimal control over their eating disorder, especially while binging. [41] X Research source Eating disorders are a mental health condition that need professional treatment, and are not something that will be grown out of. [42] X Research source
