Contributor: Staff at Timberline Knolls Residential Treatment Center
For adolescents struggling with bulimia, the holidays can be a less-than-cheerful time of year. Young people who have bulimia are often confronted with culturally approved disordered eating habits during the holidays as friends and relatives restrict their food intake so that they can binge on that big holiday meal. After the holidays are over, many people diet to try to take off all those extra pounds they gained throughout the season.
It’s not unusual for people to wait all day to eat so that they can enjoy as much food as possible since these are dishes they don’t get throughout the year. Many people overeat at holiday meals — and throughout the holiday season on various holiday treats — and compensate for all this eating through dieting and extra exercise in the days and weeks after the holidays.
But this eating and dieting culture surrounding the holidays can be incredibly harmful to a young person who is suffering from bulimia nervosa because it encourages the same disordered pattern of binge-eating and compensatory behavior associated with this condition. If your child is trying to cope with bulimia, it is likely they will need some extra support during this time of year.
Adolescents Struggling with Bulimia and the Effect
According to a 2018 study published in the journal Adolescent Health, Medicine, and Therapeutics, the median age that American adolescents begin to experience symptoms of bulimia is 12 years old.
Of a sample of more than 10,000 adolescents, the study found that nearly 1% experienced bulimia sometime within their lives, and 0.6% experienced bulimia sometime within a 12-month period.
Of the young people in the study’s sample who were struggling with bulimia, around 40% said that they engaged in purging behaviors, while the rest of the sample said that they engaged in some sort of non-purging compensatory behaviors, such as fasting or excessive exercise.
Most of the young people in the sample also struggled with mental health challenges in addition to an eating disorder, with adolescents suffering from bulimia experiencing the highest rate of coexisting conditions (88%).
Many children and adolescents in the study’s sample who reported struggling with bulimia also experienced symptoms of depression (50%) and anxiety disorders (66%), and more than half (53%) suffered from thoughts of suicide.
The Power of Family
Family can be a powerful source of support for young people, helping them navigate the various visual, verbal, and emotional eating disorder triggers that can coincide with the holidays.
According to a 2015 study published in the Journal of the American Academy of Child and Adolescent Psychiatry, family-based therapies are more effective for children and adolescents who have bulimia.
The researchers found that adolescents who had bulimia were more likely to stop engaging in disordered eating behaviors after participating in family-based therapies rather than standard treatments for adults, such as cognitive-behavioral therapy.
While the study was small, with only 130 participants ages 12-18, the researchers found that 39% of the children and adolescents who were treated with family-based therapies stopped bingeing and purging for at least four weeks, compared to 20% of those who were treated with cognitive-behavioral therapy (CBT).
Six months after the participants received treatment, both groups continued to improve. However, the researchers found that there was still a gap in success, with 44% of the family-based therapies group and 25% of the CBT group no longer engaging in bingeing and purging behaviors.
“The big take-home message is that families can really help their kids with bulimia nervosa,” James Lock, M.D., Ph.D., professor of psychiatry and behavioral sciences at Stanford University School of Medicine and co-lead author of the study, said in a news release.
Tips for Managing Adolescents Struggling with Bulimia
If your child is struggling with bulimia this holiday season, your support can help them get through a time of year when disordered eating behaviors are encouraged and even celebrated. These are just a few ways you can help them manage their symptoms:
- Open the lines of communication – Make sure your child knows that you’re here to listen so that they can share how they are feeling. This will also help you get a better understanding of what their primary challenges are as you head into the holidays.
- Make a plan – Once you know what your child’s challenges are, you can work together to create a plan for how you will get through them. If relatives start to talk about weight loss after overeating, perhaps you can come up with ways to change the subject. You can also plan to leave holiday events early if your child starts to feel overwhelmed.
- Set a meal schedule – It can be incredibly challenging to stick to a regular meal schedule during the holidays. Still, it can be a crucial component of your child’s recovery process. Rather than indulging in large holiday meals, try to eat standard meals on a regular schedule to help your child minimize the compulsion to engage in disordered eating behaviors.
- Have patience and compassion – Struggling with the symptoms of an eating disorder during a food fest or after a food fest is not easy. If your child slips up and engages in disordered eating behaviors during the holidays, be ready to support them with kindness, patience, and compassion.
The holidays may be a particularly difficult time of year for young people who are struggling with bulimia. But a patient and compassionate family support system can help them manage their symptoms so that they can experience the cheer of the season.
Digitale, E. (2015). For teens with bulimia, family-based therapy works best. Stanford Medicine News Center. Retrieved from https://med.stanford.edu/news/all-news/2015/09/for-teens-with-bulimia-family-based-therapy-works-best.html.
Hail, L. and Le Grange, D. (2018). Bulimia nervosa in adolescents: prevalence and treatment challenges. Adolescent Health, Medicine, and Therapeutics, 9, 11–16. doi:10.2147/AHMT.S135326.
About Our Sponsor:
Timberline Knolls Residential Treatment Center provides quality, holistic care to women and adolescent girls ages 12 and older. We treat individuals struggling to overcome eating disorders, substance abuse, mood and anxiety disorders, trauma and post-traumatic-stress-disorder (PTSD), and co-occurring disorders. Our campus is located on 43 wooded acres just outside Chicago. This peaceful setting offers an ideal environment for women and girls to focus on recovery.
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Reviewed & Approved on December 10, 2019, by Jacquelyn Ekern MS, LPC
Published December 10, 2019, on EatingDisorderHope.com