Caring for a Child with Bulimia Nervosa

It is estimated that as many as 3% of college-aged women have bulimia nervosa. But it is not just an affliction that affects young, college-age women. Men can struggle with bulimia, and cases for both sexes have been reported as young as nine.

Do you believe your child may have bulimia? Let’s define what bulimia nervosa is, and why it can be difficult to detect –– even among a family member.

What is Bulimia?

For many, we associate bulimia with purging – self-induced vomiting to rid the stomach of food. While this is a trait of bulimia, it is important for parents to understand its other characteristics as well:

  • Purging. Does your child disappear within an hour of eating? Do they go to a distant bathroom or leave the house? This is characteristic of bulimics
  • Binge eating, defined as eating more food at one sitting than is normal. This can be characteristic of bulimics
  • Bingeing and purging consistently over time. This is a telltale sign of bulimia
  • Feeling a lack of control during binge eating. Your child may feel helpless to stop eating during a binging episode
  • Guilt and shame at binge eating
  • Taking laxatives, enemas or diuretics to pass food more quickly
  • A self-image that is based on body image and weight instead of other traits like intelligence and creativity
  • Significant dental issues from the damage caused from purging. Acidity from vomiting, over time, can destroy the protective enamel on your child’s teeth
  • Esophageal abrasions, inflammation, and in extreme cases, hemorrhaging due to repeated vomiting. A sensitive or tender esophagus may be an indicator of bulimia

Is bulimia difficult to detect in my child?

Even with these seemingly noticeable traits, bulimia can still be difficult to detect.

parent holds the hand of a small childIndividuals with bulimia may vary from being underweight, to normal weight, to overweight. Your child may look “normal,” but their body may be ravaged inside from a lack of proper nutrients, esophageal trauma, dental abuse and psychological issues.

Secondly, it is not uncommon for a child to deny that they have an eating disorder. They may even have polished stories as to how they are eating well, or why they have thrown up after recent meals. “I’m having a stomach bug lately,” or “I’m eating three meals every day!”

How dangerous is bulimia nervosa? The physical damage caused by bulimia is serious. Left unchecked, it can lead to permanent damage to the esophagus, teeth and stomach.

With repeated, violent vomiting, tears or hemorrhaging in the esophageal tract can be extremely dangerous. Over time, the body is starved of proper nutrients which affect energy, focus and cellular development.

The psychological effects of bulimia can be similarly damaging. Fear, denial and frustration with an inability to control one’s behavior can suck the life out of their personality. Depression, anxiety and trauma are real possibilities for the bulimic.

How can I help my child?

Here are some tools to help you as a parent:

  • Listen. Listen to the words your child uses. He or she may express shame, depression or fear. Their tone may soften when they talk about eating
  • Observe. Their eye contact may waver when they discuss eating. They may look defeated, hopeless or that their life is out of control
  • Talk. If you suspect there may be a problem, talk to your child. In a calm and compassionate way, tell them what you saw or heard. Be specific. “I’m concerned about you because I heard you throwing up in the bathroom after dinner.” “I’m worried about you because you haven’t eaten dinner for several days.”
  • Monitor the Internet. Many parents do not understand the access their children have to pro- eating disorder websites. Sites extolling “thigh gap”, self-harming and avoiding detection from purging have significant traffic among children. YouTube, the most heavily used search engine among adolescents, has videos promoting eating disorders. Look for sites that use terms like “pro-ana” for anorexia and “pro-mia” for bulimia. (
  • Research. Find out how to get help for your child. The National Eating Disorder Association is a good place to start (

“What if my child gets mad or denies it?” It is common for kids to say there is nothing wrong. Affirm that you love your child and want to help. You may need to approach your child several times before they respond.

Does my child need clinical treatment to overcome bulimia nervosa?

Portrait of business colleagues holding each other and laughingAs a parent, do not expect your child will “grow out of it.” Bulimia is a physical and mental spider web that can grasp onto your child tightly. If you suspect or know your child is bulimic, know there is expert level treatment that can help.

With quality care, most bulimics can gain control over their disorder and go on to lead happy, healthy lives. Without treatment, they risk an ongoing life filled with struggle and serious health consequences.

Bottom line: get expert treatment. It will likely be the most important piece of parenting you can ever provide.

Contributor: Dr. Gregory Jantz, Founder of The Center • A Place of HOPE and author of 30 books on behavioral and mental health issues, including depression, anxiety, eating disorders, and others.

Dr. Gregory JantzAbout the author: Dr. Gregory Jantz is a best-selling author of 30 books. He is a go-to media source expert for a range of behavioral-based afflictions, as well as drug and alcohol addictions. Dr. Jantz has appeared on CNN, FOX, ABC, CBS, and has been interviewed for the New York Post, Associated Press, Family Circle, and Women’s Day. He is also a regular contributor to The Huffington Post and Psychology Today blogs. Dr. Jantz is a sought after speaker, appearing internationally. Dr. Jantz founded The Center • A Place of HOPE to help people transform their lives.

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 discussion of various issues by different concerned individuals.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on November 9, 2015
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