Bulimia nervosa, one of the most dangerous mental health diseases known to science, is shockingly common. It affects roughly 1.5% of American women, which sounds like a small number until you realize that translates to over 4 million people. Just like any other mental health disorder, people are hesitant to talk about it, especially those who have it. That’s why parents should be on the lookout for the signs and symptoms of bulimia nervosa – a child who is struggling with bulimia needs help, but might not know how to ask for it.
Behavioural symptoms and signs of bulimia nervosa
People with bulimia nervosa share common, distinctive disordered eating patterns and other behaviours that provide a signal that eating disorder treatment might be necessary. Here are some of the major behavioural signs there is a problem to be addressed:
- Frequent dieting. Almost every person with an eating disorder has a negative body image. They might wear baggy clothes to hide the shape of their body, express unhappiness with their weight, or obsess over imaginary flaws in their appearance. A very common behaviour among people with bulimia nervosa is engaging in a series of crash diets. Cutting out certain foods like carbs, going on ‘juice cleanses’ or obsessing over calories are all indicators someone is at risk of developing bulimia nervosa.
- Binge eating followed by self-induced vomiting and other purging behaviours. This is the defining characteristic of bulimia nervosa, as laid out in the DSM-5. Often spurred on by dieting, the child will binge eat in secret, and then purge the calories they took in by forcing themselves to vomit, taking pills (i.e., laxatives) frequently, or excessively exercising. Parents should be on the lookout for food wrappers or food went missing on a regular basis. If they hear, see, or smell the signs of vomiting, including stained teeth and fingers, a doctor or psychiatrist’s attention is warranted.
- Food rituals and discomfort at mealtimes. Bulimia nervosa brings with it a troubled relationship with food, especially when eating in a group. They will often develop food rituals such as eating their food in a particular order or making sure different foods are not touching on the plate. They may also eat sparingly with the group, saying they are on a diet and don’t want to eat too much, only to binge eat later.
Physical signs of bulimia nervosa
Unlike the common perception of a person with an eating disorder, bulimia nervosa doesn’t always result in extreme weight loss. Although weight loss is possible, most people with the disorder are at a regular weight or even overweight (medically speaking). However, there are some physical signs of bulimia nervosa which can be more easily identified.
- Signs related to vomiting. Parents should watch and listen for signs of vomiting. After frequently purging for an extended period, the teeth will become discoloured and develop cavities from the stomach acid. Callouses on the fingers and knuckles also appear with repeated self-induced vomiting. Swollen glands in the throat and a sore throat are also common in people with bulimia nervosa.
- Sudden weight changes. Because people with bulimia nervosa are often on a strict diet, but also binge eat, they often experience sudden fluctuations in their weight. This doesn’t necessarily mean weight loss; despite the purging efforts, frequent binge eating episodes can lead to weight gain as well. Rapid weight changes wreak havoc on the body. They can result in diabetes, gastrointestinal problems, heart disease, and decreased brain function if left untreated.
- Malnutrition and nutrient deficiencies. Combining frequent dieting, purging, and eating ’empty calories’ such as potato chips or snack cakes (which are the kinds of foods often eating during a binge eating episode) can result in certain signs of malnutrition. These can include several different physical effects, such as a sense of always being cold, persistent headaches, fatigue, and dizziness, and electrolyte imbalances caused by dehydration. After an extended period of nutritional deficiency, the individual’s hair becomes dry and brittle and may thin out. In extreme cases, there may be small, fine hairs growing all over the body, a condition called lanugo (although this is more associated with anorexia nervosa than bulimia nervosa). The skin can be extremely dry as well and may show signs of yellowing as the result of a severely restricted food intake.
There are other signs of bulimia nervosa than those we’ve listed here. You can check out some of them here. However, these behavioural and physical signals are a good start for parents who are concerned about their child’s eating patterns and mental health. If you observe any of these signs, you shouldn’t hesitate to reach out for professional help. The worst thing that could happen is you could be wrong. The best thing is that you could save your child’s life.
Image credit: Freepik
Dennis Relojo-Howell is the managing director of Psychreg. He interviews people within psychology, mental health, and well-being on his YouTube channel, The DRH Show.
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