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Bulimia in Teens

Typically the result of depression or some form of self-hatred, bulimia causes many victims to binge and purge — overeating and then forcibly vomiting — to the point where they critically harm their body and mind. Millions of Americans, especially women, report having this eating disorder at some point in their life.


6 min read

What Is Bulimia?

upset teen looking at scale in bathroom

Bulimia, or bulimia nervosa, is an eating disorder marked by volatile swings in mood and diet routines. Teens suffering from this problem will binge on large amounts of food and then attempt to undo their intake with extreme, unhealthy behaviors. It’s a legitimate mental illness, typically beginning during adolescence and impacting females — only 5–15% of patients are male.

The two types of this disorder are:

  • Purging Bulimia – ridding oneself of recently consumed food by vomiting, enemas or abusing laxatives
  • Non-Purging Bulimia – obsessively exercising or fasting following a period of overeating

Many patients exhibit both purging and non-purging behaviors. These behaviors often appear over time in teens with anorexia — a disorder that’s characterized by a distorted body image and food restriction. Half of all teens with anorexia develop bulimia patterns. Cases of bulimia tend to involve people with body image issues and those who participate in activities that emphasize beauty.

Though records of purging date back centuries, the phenomenon of bulimia hit the mainstream in the late 20th century, as unrealistic body standards became increasingly commonplace. In 1979, the medical community published the first clinical paper on bulimia nervosa. Between 1988 and 1993, the incidence of bulimia in females aged 10–39 tripled.

Males vs. Females

Bulimia is predominantly seen in females. Up to 4.2% of American women will develop some degree of bulimia in their lifetime, whereas only around 0.1% of men are currently affected. Nearly 70% of middle and high school girls say that their idea of a perfect body shape is influenced by pictures in magazines. This nationwide (if not worldwide) dilemma — paired with the exploding rates of depression, anxiety, OCD and other co-occurring mental health disorders in teenagers — causes many to feel that we’ve only seen the beginning of the bulimia problem.

The prevalence of bulimia is equal across white, black, Asian and Hispanic Americans. While young women are most at risk, 14% of gay men also appear to struggle with bulimia.

What Causes Bulimia?

girl with head in hands with food in bathroom

Bulimia is caused by an irrational and overwhelming self-image issue, exacerbated by stressful life events or overbearing social circumstances. For instance, girls on the cheerleading squad may feel an added pressure to be in shape. The constant pursuit of fitness can cause teens to “snap,” and develop this love/hate perception of eating that snowballs into an eating disorder. They will diet to the point that it deregulates their appetite, which naturally results in the urge to binge. It then quickly turns into a vicious cycle that severely impairs their way of thinking.

In a number of cases, children are susceptible to bulimia due to more pervasive problems. There are occasional genetic complications, such as lowered serotonergic functioning, vulnerability to obesity or a family history of eating disorders — some research shows that genes related to eating disorders are transferable at birth. Also, teens with borderline personality disorder and other certain mental health disorders are far more likely than their peers to struggle with bulimia. Around 30% of women with bulimia report a history of anorexia.

Symptoms of Bulimia

Because of the obsessive back-and-forth nature of bulimia, it can be difficult to identify a problem by your teen’s weight alone. Unlike teens with binge eating disorder or anorexia, people with bulimia tend to maintain their normal weight or only fluctuate slightly — despite the tormented habits they develop.

Keep an eye out for these other possible signs that your teen is bulimic. Symptoms can include:

  • Binging at least twice a week
  • Feeling like they can’t control themselves while binging
  • Eating in secret, and very quickly
  • Thinking constantly about their weight and about food
  • During binging episodes, eating until there’s no food left, their stomach is very uncomfortable, or someone interrupts them
  • Feeling guilt or shame after each episode

You may notice additional odd behaviors. Your son or daughter may start hanging out with different friends (or no friends at all), having difficulty in school, growing discouraged or acting increasingly impulsive. You may also notice things like:

  • Excessive exercise or fasting
  • Inappropriate use of laxatives, diuretics or other cathartics
  • Peculiar eating “rituals”
  • In girls, irregular or absent menstrual periods
  • Scarring on the back of fingers from self-induced vomiting

Risks of Bulimia

If your teen develops bulimia nervosa, they’re at risk for a myriad of problems — physically, mentally and otherwise. These rampant, inconsistent dieting patterns do a number on a young person’s internal organs, and can land them in the hospital with serious complications. If that’s not enough, it greatly increases their chance of developmental disorders and consequences in all aspects of their life.

Physical side effects of bulimia can include:

  • Dehydration
  • Fainting and loss of consciousness
  • Tooth decay
  • Osteoporosis
  • Long-term digestive problems
  • Low body temperature
  • Inflamed or torn esophagus
  • Ruptured stomach
  • Heart problems

Surviving each day as a teenager is troublesome enough. When living with this disturbing illness, and restructuring their lifestyle to meet its demands, teens are prone to develop severe psychological side effects. These can include:

Teens living with bulimia may watch their personal life crumble around them, and unless parents intervene, their woes may multiply over the years. Teens with bulimia are at risk for troubled relationships, problems in school, job instability and persistent social difficulties. Oftentimes, treatment is the only way for them to get well again.

“Family Based Therapy is the treatment of choice for adolescents with bulimia nervosa, because it works faster and maintains its impact over time.”

Daniel Le GrangeChildren’s health professor at UCSF Benioff Children’s Hospital San Francisco

Does My Teenager Need Professional Treatment?

upset teen in group therapy

If your believe your child is suffering from substance addiction or bulimia, don’t leave them to fight these disorders on their own. Neither addictions nor eating disorders often resolve themselves on their own — professional drug rehab treatment is usually necessary. The longer a disorder is allowed to endure, the more difficult recovery becomes. Your child needs help — reach out to a treatment professional immediately.

Though there are hundreds of teen-focused eating disorder treatment centers located around the country, not all of them are equipped to deal with coexisting substance addictions. We at are able to discuss your family’s situation with you, and help you choose the right path to recovery for your child. Our help comes to you free of cost and obligation. Take the first step towards healing for your teen — just reach out.


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