Bulimia nervosa

Bulimia nervosa can be difficult to identify because people suffering from this obsessive-compulsive disorder often look normal. Key behaviors of this disease are binge eating and purging.

By definition, bulimia nervosa includes binge eating (eating a very large amount of food) at least twice a week for at least three months and recurrent, inappropriate behaviors to prevent weight gain. These behaviors may include purging (vomiting/laxative abuse) and/or fasting at least twice a week for at least three months.

Symptoms and behaviors

Symptoms and behaviors include:

  • Eating large amounts of food, out of control eating.
  • Eating “trigger” foods in large quantities, such as carbs – ice cream, muffins, cookies and peanut butter are common examples of trigger foods.
  • Going to the bathroom immediately after meals (to purge).
  • Resistance to eating in front of others.
  • Avoidance of eating in restaurants – purging in a restaurant is more difficult than at home.
  • Depression, irritability, withdrawal.
  • Change in friendships.
  • Expressed concern by friends or family of friends regarding her weight and behavior.
  • Impulsive behavior. For example, erratic driving or sudden decisions that seems extreme.
  • Self-injury – cutting, burning, biting.
  • Diarrhea, abdominal cramps – usually from laxative abuse.
  • Taking or hiding laxatives.
  • Being less focused on school, grades dropping.
  • Anxiety.
  • Calloused or bruised fingers or hands (from purging).


The most important first step in treatment is recognizing the signs and bringing your child to medical attention. If a diagnosis of bulimia nervosa is made, we will work with your child to help her understand her diagnosis, its gravity and treatment options. Without treatment, bulimia is a dangerous disorder with a death rate of 6 percent per decade. With early treatment, the chance for recovery is good.

Treatments options include:

  • Outpatient: A team that includes a doctor, a dietician and a psychologist work closely with your child and your family to help her recover. In some cases, a psychiatrist can also be helpful.
  • Inpatient: Certain signs and symptoms of severe bulimia will require us to hospitalize your child for monitoring and medically supervised feedings. The average length of stay for our patients admitted to Sacred Heart Medical Center at RiverBend is one week. This time is spent ensuring that your child’s internal organs are stable to continue recovery. This stay must be followed either by outpatient or residential care.
  • Residential: A child who cannot recover from bulimia without constant supervision by trained professionals will be a candidate for one of many good residential programs in the U.S. We can help you select a good residential program for your family.

Eating disorders

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Does your child have an eating disorder?

At least 30 million people in the United States suffer from an eating disorder at some point in their lives, according to the National Institute of Mental Health. More than 2 million are children between the ages of 13-18.