What is Bulimia

According to the United States Department of Health and Human Services' Substance Abuse & Mental Health Services Administration (SAMHSA) (1), bulimia is an eating disorder that mostly affects young women between the ages of 12 and 25 of normal or near normal weight. Characteristics of bulimia include episodic binge eating followed by feelings of guilt and self-condemnation.

Teens suffering from bulimia often show signs of the eating disorder by eating a large amount of food in a small time frame and immediately purging themselves of the food ingested by causing themselves to vomit. Other ways the bulimic uses to rid the body of food eaten during a binge include laxatives, diuretics (water pills), and fasting. Often called the "binge/purge" cycle, this behavior is brought about by an extreme fear of gaining weight.

Treatment of Bulimia

Treatment for teens suffering from bulimia has been advancing in recent years. In 2002, the American Psychological Association reported on a study conducted in 2000 about two types of psychotherapy that have met success in the treatment of bulimia (2). One type focuses on the symptoms of bulimia while the other aims to address issues the bulimic may have with relationships.

Cognitive behavioral therapy helps the bulimic address the symptoms of bulimia and focuses on the negative thoughts associated with their weight and appearance. This therapy also helps guide the bulimic to make positive diet changes.

Interpersonal psychotherapy aims to improve the worth of the bulimic's current relationships and to improve any negative aspects of those relationships by dealing with issues directly. This therapy also helps the bulimic to form a wider social network.

A study reported in the August 2000 American Journal of Psychiatry (Vol. 157, No. 8) reported that bulimics who responded well to either of these types of therapy did so within the first six to eight sessions. The report further states that randomly selected patients who did not respond to the two types of therapy did respond to antidepressant medication such as Prozac.

Studies suggest that bulimia is manifested in women between the ages of 18 and 24. Psychologist Daniel Le Grange, Ph.D., however, believes that by exploring bulimic patients' histories more thoroughly, the cycle of bingeing and purging often begins as early as 15 or 16.

How to Prevent Bulimia

According to the Public Broadcasting System's Perfect Illusions website (3), there are steps parents, teachers, coaches and others who work with teens can take to help avoid bulimia. A few of these include: 

• Modifying and adapting expectations you have of your teen. 
• Examining your own perceptions and attitudes towards food, body image, physical appearance and exercise. 
• Do not give off the message that you cannot do activities such as dance, swim, or wear certain types of clothing because of the way you look or how much you weigh. 
• Encourage eating in response to physical hunger. 
• Encourage eating a variety of foods. 
• Help teens to appreciate their bodies and encourage them to engage in physical activity. 
• Do not use food as a reward or punishment. 
• Do not criticize your own weight or the way you look by avoiding the use of such phrases as "I'm too fat" or "I've got to lose weight." 
• Love, accept, and acknowledge the teen's value verbally.

(For a more extensive list of ways to help prevent bulimia, visit the PBS website listed in the Sources)

Bulimia Sources

1. Cited in "Teen Eating Disorder Statistics on Anorexia Bulimia," Family First Aid Help For Troubled Teens, www.familyfirstaid.org/eating-disorders.html
2. Tori DeAngelis, "Promising Treatments for Anorexia and Bulimia: Research Boosts Support for Tough-To-Treat Eating Disorders," Monitor on Psychology 33, no. 3 (2002), www.apa.org/monitor/mar02/promising.html.
3. 3. Public Broadcasting Service. "Perfect Illusions: Eating Disorders and the Family, Prevention Strategies," www.pbs.org/perfectillusions/eatingdisorders/preventing_strategies.html

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