Psychotherapeutic: Behavioral management is the first-line treatment for bulimia—professionals will address the dangerous and worrying purging behavior and ensure that your child is healthy before moving on to more long-lasting interventions.
Cognitive behavioral therapy is employed to alter your child’s body image and eating habits by teaching them how their thoughts turn into unwanted, even disturbing feelings and actions. CBT is effective in 50 to 60% of those treated. Interpersonal therapy, which focuses on how the child’s relationships with others impact her feelings and actions, is also employed.
Pharmacological: If behavioral therapy does not yield the desired results, antidepressant medications—particularly selective serotonin reuptake inhibitors or SSRIs—can have positive results.
In addition, nutrition education may be necessary to convince your child of the disastrous effects of her disorder, and may help her amend her behavior.
No. While many people with bulimia find that they can effectively manage the desire to binge and purge after treatment, it is a lifelong undertaking.
Can it be fatal?
Yes. Though fewer deaths are associated with bulimia than anorexia, because a child with bulimia may maintain a relatively normal weight, the activities she uses to maintain it put stress on the body that can prove fatal. Suicide is also a serious risk.
Is there medication for bulimia?
While psychotherapy, particularly cognitive behavioral therapy and interpersonal therapy, are preferred treatments, some antidepressants have proven effective in combating the symptoms of bulimia.
What is a binge episode?
A binge episode is defined as “eating, in a discrete period of time, an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances” and having “a sense of lack of control over eating during the episode.” Experts note that while the first criteria may be hard to quantify, the sense of lack of control during the binge episode, and the attempt to compensate by purging, are the keys to a diagnosis of bulimia.
How can I tell?
It’s not easy to tell—especially if your child is not underweight, or is even overweight—when a child has been using drastic measures to void food from her body. But there are signs—secretive absences from the table, abnormal intake of water, going long periods without eating at all, teeth eroded from exposure to stomach acids, even scars on the fingers from self-induced vomiting.
When do symptoms usually start?
The onset of bulimia is later than anorexia; while anorexia usually presents around puberty, say 14, bulimics start to show symptoms around the transition to adulthood, say 19. But the disorder can also manifest earlier—and later.