Filling the void, purging the pain

Bulimia is just that: binge eating to fill a dark emptiness inside and then afterwards feeling so guilty for eating so much that the only choice the sufferer feels they have is to get rid of everything they've just eaten.

Bulimia nervosa is an eating disorder that affects mostly young women between the ages of 12 and 25.  They are usually of normal, or near normal weight.  Unlike with anorexia, these teens seldom look "skinny" so their disorder often goes unnoticed.

Teens suffering from bulimia show signs of the eating disorder by eating a lot of food in a very short time and then immediately purging themselves.  Sufferers usually make themselves vomit but may also use laxatives, diuretics or fasting.  This is often referred to as the binge/purge cycle. This behaviour is brought about by desperately craving large amounts of food for comfort, but still having an extreme fear of gaining weight.

How can you tell if your teen has bulimia? These are the signs:
  • Constant weight fluctuation of between 2-5kg
  • Insomnia or excessive sleeping
  • Brittle nails and dull hair
  • Frequently dizzy or fainting spells
  • May throw up blood
  • Stomach aches
  • Chronic sore throats
  • Constant headaches
  • Knuckles appear calloused, scratched or bruised (from forcing themselves to vomit)
  • Frequently tired
  • Complaints of heartburn
  • Eyes look bloodshot
  • Swollen throat glands
  • Breath may smell bad
  • The number on the scale results in extreme depression or elation
  • Eating in isolation
  • Food hoarding

Teens that may be susceptible to bulimia tend to show the following tendencies:
  • Low self-esteem
  • Feel incredibly bad after eating high calorie food
  • Experience depression and mood swings
  • Battle to accept compliments, especially regarding their weight

Things parents can do to help minimise the risk to their kids of suffering from bulimia:
  • Check your own expectations - do you wish that your child was thinner? If so, they pick up on these feelings even if you don't voice them.
  • Be careful how you speak about food, body image, physical appearance and exercise
  • Avoid sending the message that the way someone looks – or how much they weigh – restricts which activities they can do.
  • Encourage eating at regular times and as a response to hunger, not an emotional need
  • Encourage eating a variety of foods
  • If your child seems depressed, seek help from a counselor or psychologist
  • Never use food or sweets as a reward or punishment
  • Don't criticise your own weight or that of others in front of your child
  • Give your child tons of love, especially verbally.  Make sure they know you accept them no matter what.

How to help your teen if he/she has bulimia:
  • It is essential that your child receives therapy. This could involve cognitive behavioral therapy which helps teens identify negative thoughts associated with their weight and appearance and helps guide your teen to make positive diet changes and find healthy ways of emotional fulfillment.
  • Most often, teens with bulimia tend to have interpersonal problems.  A goal of therapy is to improve your teen's relationships by helping him/her deal with issues and not to bottle up their feelings.  
  • Response to therapy, if the child is willing, is fairly fast.  Teens that don't respond well to therapy may be put on antidepressants.  You need to remember that, essentially, bulimia is more an emotional problem than a "food" problem and once your child's depression, anxiety and self-esteem has been addressed, the eating disorder itself is found to dramatically improve.

Have you or someone you know struggled with an eating disorder? How do you control it?

Michelle Minnaar has degrees in Psychology and Education and regularly conducts workshops for teens and parents on topics such as self-esteem, depression, eating disorders, drug abuse and learning problems.

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