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Symptoms of Bulimia Nervosa Parents Might Not Know

Eating disorders like bulimia nervosa are a huge worry for parents of teenagers and young adults, but it’s easy to miss the symptoms beyond the characteristic purging behaviors/ Why? Because many f the signs of bulimia nervosa are less well-known and subtle. Because of this, people may be less likely to seek bulimia nervosa treatment which can help them or their loved one recover.

Compounding the difficulty of recognizing this disorder are several preconceived notions about who can be affected by bulimia nervosa. the fact is, bulimia nervosa treatment centers treat people of all ages, races, ethnicities, and genders. In other words, it’s not possible simply to look at a person and assume to understand how this person feels about their body or their relationship with food. With the knowledge that anyone can be afflicted, parents can be more watchful and spot bulimia nervosa more easily.

Binging and purging are the notable symptoms of bulimia nervosa, and most people have at least heard of them.That being said, the defining behavior of the disorder is experiencing both episodes of binge eating (eating a large amount in a short time) followed by compensatory actions to remove those calories (these actions often include vomiting, laxative abuse, and extreme exercise).

More Than One Behavior

There is also a multitude of other symptoms, emotional, behavioral, and physical, that can come with a diagnosis of bulimia nervosa, and each of them can have negative effects on a person’s life.

It’s important when discussing bulimia nervosa, its symptoms, and its effects, to understand where the disorder comes from and what causes it. Bulimia nervosa treatment programs normally individualize their treatment plans around an individual’s specific underlying causes, so parents looking to spot the signs of the disorder should also be aware of potential causes and be able to identify them in their kids.

Understanding Bulimia Nervosa Causes

Most official estimates indicate that at least 1.5% of young women and 0.5% of young men will experience bulimia nervosa at some point in their lifetime. This sounds like a small percentage, but extrapolated to the United States alone, this means millions of people will struggle with the disorder.

Like most forms of mental health disorder, there is usually not a singular cause or origin of bulimia nervosa, but rather a combination of elements that contribute to the development of the disorder. Instead of a single cause like the virus that causes chickenpox or another disease, there are usually several different facts.

Generally, both environmental and genetic factors influence whether a person develops bulimia nervosa or other kinds of eating disorders. These factors may include:

  • Social pressures to meet an idealized body type
  • Focus on perfectionism and weight loss at an early age
  • Family history of mental illness, especially other eating disorders
  • Personal history of trauma or abuse
  • Participation in sports or activities which require or idealize weight loss
  • Distorted body image (body dysmorphia)

In spite of common perceptions, both men and women can experience bulimia nervosa, as the NIMH and NEDA indicate in their studies. Likewise, while the average age of onset is between 18 and 19 years old, bulimia nervosa can affect people of all ages.

8 Lesser-Known Signs and Symptoms of Bulimia Nervosa

While binging and purging are core characteristics of the person living with bulimia nervosa, the disorder affects almost every aspect of a person’s life. Many people with bulimia nervosa take precautions to avoid their binge and purge cycle from being discovered, so parents who are concerned about the disorder taking hold should keep an eye out for other telltale symptoms of an eating disorder.

Take a look at these common signs and symptoms of bulimia nervosa that you might not have known about:

  1. Thirst and dehydration. This is more common in purging-type bulimia nervosa, in which frequent vomiting drains the body of fluids. Signs of dehydration include dark and infrequent urine, fatigue, dizziness, lightheadedness, fainting, extreme thirst, and confusion or lethargy.
  2. Sore throats and deteriorating teeth. This occurs due to repeated exposure to stomach acids. These powerful digestive acids can cause serious esophageal pain and sores and can etch away and cause discoloration on the person’s teeth. Sudden tooth decay is a strong sign there has been a lot of exposure to vomit – ask your child’s dentist if anything unusual is happening.
  3. Swollen glands in the neck and jaw. The stresses of purging can also affect the sensitive glands in a person’s neck, leading to swollen glands and rounded cheeks. This may be due to exposure to stomach acids, as well as the stresses in the musculature of vomiting, and a “production overdrive” by the glands in response to the gag reflex.
  4. Gastrointestinal problems.Both the binging and purging parts of the bulimia nervosa cycle can cause GI complaints such as acid reflux, heartburn, nausea, bloating, constipation, intestinal distress, and gas. In more severe cases, ulcers or stomach cancer may occur.
  5. Electrolyte imbalances. Related to dehydration, people with bulimia nervosa are at risk for disrupting electrolyte levels in their bodies. Purging, via vomiting or other means like laxative abuse or excessive exercise, can reduce the levels of essential electrolyteslike sodium, potassium, calcium, and other nutrients. These electrolytes are essential for nerve and neurological function as well as the workings of the musculature and even some bone marrow functions. Unfortunately, this risk for electrolyte imbalance and nutritional deficiencies partially explains why research shows people with bulimia nervosa are at an increased risk for medical complications including high blood pressure, abnormal heartbeat, heart attack, insomnia, type 2 diabetes, and more.
  6. Callouses, cuts, and discoloration on the hands and fingers. Self-induced vomiting using the fingers to cause the gag reflex can cause injuries to the person’s fingers. After repeated purging episodes the repeated scraping of the knuckles against the teeth. This can lead to the frequent appearance of scabs, scrapes, and scars. Exposure to the stomach acids can also permanently discolor the skin on the fingers after repeated episodes.
  7. Co-Occurring disorders. A person with bulimia nervosa often experiences body dysmorphia, or a distorted or negative self-perception and dissatisfaction with their body. He or she may be fearful of gaining weight and show signs of perfectionism and disappointment in their ability to reach perfection.Co-occurring psychological and psychiatric disorders are very common in people with bulimia nervosa; these can include anxiety, depression, and other mood disorders.
  8. Non-vomiting purging behaviors. A person with bulimia nervosa may exercise excessively, go on extreme diets or fasting periods after a binge eating episode, or compulsively exercise to “burn calories.” Exercise addiction may be a standalone disorder, but it is often present in cases of eating disorders. Any of these purging behaviors can be dangerous to a person’s heath, just as the more well-known vomiting form of purging.

Spot the Signs and Reach Out for Help

Many of these symptoms can fly under the radar; many people are willing to overlook the symptoms of an eating disorder if the person in question doesn’t fit a specific body type. There is an incorrect assumption among many people that everyone with an eating disorder is thin or skinny. However, people with bulimia nervosa don’t necessarily lose a lot of weight or become medically underweight.

For that reason, parents trying to identify an eating disorder like bulimia nervosa in their kids shouldn’t depend on their child’s weight as an indicator of the disorder. Instead, they should look for signs of the binge/purge cycle and the other signs listed above. If they’re present, it’s time to consider professional eating disorder treatment programs.

You can reach out directly or speak to your doctor or therapist first. Either way, it’s key to act quickly. Like other mental health disorders, early action helps make recovery faster and smoother. Calling a professional eating disorder treatment facility can be a useful resource because the admissions specialists are equipped to assess the situation and make recommendations.

Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.
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