Teen Bulimia Treatment

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One of the most common eating disorders among teenagers, bulimia is a dangerous disease that can quickly take happy, healthy young people and put their health and lives at risk. Millions of Americans – teenagers in particular – suffer from bulimia, but few get the appropriate treatment they need to get well.

Of the teenagers diagnosed with bulimia, 90 percent are girls and young women, according to Current Opinion in Psychology 2006 Jul;19(4):389-94. The journal reported that since the 1970s, diagnoses of bulimia have been rising in number. In the year 2000, new diagnoses were pinpointed at 6.6 per 100,000.

According to a study published at Clinical Evidence Online 2008 Jun 12, up to one percent of girls and young women have bulimia. This means that they are intensely preoccupied with their weight, experience episodes of uncontrolled binge eating, and go to extremes to avoid the risk of gaining weight. The bad news is that teen bulimia treatment is difficult to diagnose because many living with the disorder have a normal body weight and the signs are not necessarily immediately recognizable. The good news is that Clinical Evidence Online also reports that 10 years after the diagnosis, about 50 percent of bulimia patients will make a full recovery and 33 percent will make a partial recovery, leaving only 10 to 20 percent still experiencing issues with the disorder.

If you believe that your teen is living with an eating disorder like bulimia, teen-specific treatment is available at Newport Academy. Contact us today for more information about our programs and to learn more about how we can help your teen and your family heal after the ordeal of bulimia.

What Is Bulimia?

Bulimia, or bulimia nervosa, is an eating disorder in which the individual engages in binge-and-purge behavior in order to maintain an unrealistic self-image. The condition is typified by first bingeing, or eating a large meal, and then purging by using vomiting, laxatives or other methods to rid the body of the calories before they can be absorbed. In addition to being socially unacceptable behavior, the binging and purging that accompanies bulimia is exceedingly dangerous to the health and well-being of the individual.

According to WomensHealth.gov, a bulimic teenager may indulge in the behavior because he or she feels that it is impossible to control the amount of food ingested to achieve the body they want, have a fear of gaining weight or are just unhappy with their appearance. Rather than limiting portions, the patient will purposely sit down to eat between 5,000 and 15,000 calories in a sitting before immediately purging. To aid in ridding the body of calories, the patient may also exercise frequently, go through periods of eating little or nothing at all, or take diuretics and other over-the-counter medications to lose weight, including water weight.

Why Is Teen Bulimia So Dangerous?

Bulimia is especially insidious when it occurs in young people. During the teen years and on through the early 20s, many of the body's most crucial organs (repertory, reproductive, etc.) and functions are developing. Bulimia can stunt the progress of this development, thus causing problems that can last a lifetime. According to the US Department of Health and Human Services, included among the many harmful physical effects that stem from bulimia are:

• Mental wellness issues including depression, low self-esteem, anxiety, fear of gaining weight, and an unrealistic self-image
• Oral ailments including enamel and gum erosion, cavities, gum disease, and swelling and soreness of the cheeks
• Inflammation and potential rupture of the esophagus
• Heart problems including arrhythmia, heart failure, irregular heartbeat, low pulse and low blood pressure
• Kidney malfunction due to the abuse of diuretics
• Intestinal and stomach issues like diarrhea, stomach cramps, bloating, ulcers and constipation

Dehydration, anemia, weakened muscles due to loss of muscle mass, amenorrhea and death are all possible when bulimia is an issue, as well.

Causes of Bulimia

According to a study published in Psychology Bulletin 2002 Sep;128(5):825-48, the cultural pressure to be thin and the constant promotion of dieting and weight loss tools contribute to the development of bulimia among teens with low self-esteem and weight gain issues. Why then do some teen boys and girls develop the issue while others don’t? A study published in Archives of General Psychiatry 1997 Jun;54(6):509-17 reports that there are a number of other factors that can be contributing causes in the development of bulimia. These include:

• Obesity
• Co-occurring mood disorders
• A history of sexual or physical abuse
• Obesity in parents or guardians
• Drug and alcohol abuse
• Low self-esteem
• Unstable home life
• Pressure to be perfect, either internal or external

Another study published in Clinical Pediatrics 1989 Mar;28(3):123-6 suggests that bulimia may also be inherited or related to certain genotypes.

Bulimia and Teen Boys

Bulimia can strike anyone at any point in their lives, but the largest percentage of cases are found among young women between the ages of 13 and 25. Less widely reported, however, is the fact that men can also suffer from bulimia as well as other eating disorders. Some reports say that as many as 10 percent of all bulimia cases involve men and that the number could be even higher due to the fact that fewer men seek psychological treatment or care.

According to a study published in Pediatric Annals 1984 Dec;13(12):901-4, 907, there is often a different motivation for weight loss among teen boys who struggle with bulimia as compared to their female peers. In many cases, the goal is to lose weight for a sport, like wrestling, in which the exact weight determines competitive status or ability to compete. In other cases, when obesity or being overweight is the issue, teen boys may turn to bulimic behaviors in order to avoid being teased about their appearance.

Early intervention and formal treatment have been shown to be extremely effective among teen boys, with a focus of learning how to handle challenges directly rather than indirectly through an eating disorder.

Diagnosing Teen Bulimia

The patient’s first step to bulimia treatment is a complete diagnosis and evaluation. It is important for the medical team to begin by determining the severity of the disorder and to learn whether or not the patient is contending with other co-occurring mental health issues or medical disorders related to long-term bulimia.

According to Medline Plus, bulimia treatment for teens begins with the initial meeting with medical and psychiatric professionals who specialize in the treatment of eating disorders. A medical doctor will first make sure that physical stabilization isn’t necessary. If there are issues of anorexia, severe depression, or if drugs are necessary to get the bulimia under control, hospitalization will be necessary until the patient is stabilized and ready to move forward. If none of these issues are present, the patient will likely be checked for rashes, pimples, broken blood vessels in the eyes from straining to vomit, and cuts along the fingers and knuckles from forcing oneself to purge as well as given a few different tests to determine levels of dehydration and certain vitamins and minerals in the blood.

A dental exam will also be necessary to determine the state of oral health and check for issues like gingivitis, cavities, dry mouth or erosion of tooth enamel.

Next, a psychiatric evaluation will be necessary. In some cases, co-occurring disorders like drug and alcohol dependence, depression, anxiety or other serious issues may be present alongside bulimia in teens. It’s important to identify these issues early in order to create a treatment plan that addresses all problems simultaneously, thus increasing the chances for success in recovery.

Bulimia Is Treatable

According to the US Department of Health and Human Services Office on Women’s Health, bulimia is absolutely treatable as long as certain points of care are provided. These include:

• Team of medical professionals. Rather than “piece mealing” treatment across providers and bulimia programs, it is far more effective to choose a program that is run by a team of professionals who specialize in the treatment of eating disorders for teens.
• Nutritional counseling and education. Learning how to have a functional relationship with food is imperative, and part of bulimia treatment should provide your teen with the opportunity to practice the supervised planning and preparation of healthy meals.
• Cognitive Behavioral Therapy (CBT). Different types of therapy will be more or less effective for different patients, but CBT tailored for the treatment of bulimia has been shown to be effective in helping teen address underlying issues that drive bulimia and learn safer coping mechanisms.
• Monitored meal times. Because the issue is with eating, it is important that patients are supervised by staff members before, during and after meals to ensure that proper behaviors are chosen.
• Medication. In some cases, medication may be appropriate to stabilize the patient initially during treatment and beyond. Antidepressants – especially fluoxetine or Prozac, the only medication FDA-approved for the treatment of bulimia – may be helpful in fighting associated depression and anxiety.
• Overeaters Anonymous. 12-step programs can be an excellent resource to augment outpatient treatment or incorporate into inpatient treatment. Available everywhere, they increase the chances of success for teen patients because they help make the transition from treatment to home more seamless.

The A.D.A.M. Medical Encyclopedia reports that support groups just for teens with an eating disorder or bulimia can also be an effective form of treatment. Teens, especially, benefit from finding that they are not alone in their issues with eating disorders and gain support and strength from peers.

It is important to note that there is no such thing as a cure for bulimia. However, a combination of the treatments can be effective when a comprehensive treatment plan is created according to personal need and diligently followed. Though relapse is common, it does not have to be a permanent setback; in fact, it can be used as a learning opportunity to help increase the length of time spent in remission following the relapse.

How to Help Your Teen Fight Bulimia

According to the National Eating Disorders Association, help for teens living with bulimia starts when their parents recognize the symptoms and get involved. There are a number of suggested measures for parents to take that will help their teen move closer to treatment and a more balanced relationship with food and self. They include:

• Open the lines of communication. Parents who are not already in regular communication with teens can start the process by just sitting down for a talk. Formally or informally, the initial conversations need not be serious, but soon it will be important to find a private place to discuss the issue of eating issues and the possibility of treatment.
• Be honest. Parents should feel comfortable expressing their concerns honestly. Possible topics include the health issues related to bulimia, hopes for treatment and suspected signs of bulimia.
• Remain calm. Parents of teens living with bulimia express feeling a range of emotions including anger, frustration, sadness and fear. Though those are all valid emotions, it’s important to keep their expression to a minimum while speaking directly with teens.
• Suggest therapy. Before jumping into a discussion of a full-fledged inpatient treatment program, parents can suggest a few sessions with a therapist who specializes in the treatment of bulimia and has experience working with teenagers.
• Don’t argue. Chances are, parents will come up against resistance when they suggest that their teen is bulimic or might benefit from therapy for the issue. Fighting won’t help and may just create new issues.
• Remain firm. Though arguing won’t help, parents are encouraged to stand their ground and make sure that their teen sees a therapist for the issue of bulimia.
• Remain supportive. No matter what the teen’s response to the discussion of bulimia and treatment, it is important that parents remain nonjudgmental and make a point of letting their teen know that they are loved and supported no matter what.

Newport Academy Provides Help for Teens With Bulimia

The eating disorder treatment programs at Newport Academy not only help teenagers overcome their fight with bulimia but provide them with the tools they will need to start making better choices in order to build a more contented and balanced life. By working closely with the counselors at Newport Academy, every young person will receive customized care that best addresses his or her needs. If your teenager is struggling with bulimia or another eating disorder, contact Newport Academy today.