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Supporting children and young people with bulimia

Information for parents and carers to support children and young people with bulimia.

What is Bulimia?

Bulimia is a mental illness which can make people feel like they don't have control over their eating or food habits. People who have bulimia tend to eat a lot of food at once (binging) and then try to get rid of it quickly (purging), this could be by throwing up, fasting, using laxatives or doing a lot of exercise. 

Signs that a child or young person may be affected by bulimia 

Changes in behaviour are noticeable earlier than physical changes. These behavioural changes include secrecy concerning food; eating alone or hiding food. They may compare their body, weight or appearance with others. They may have mood swings, withdrawal and irritability.  

Physical changes can include tiredness, bloating, stomach pain, poor skin, teeth and hair. Weight change is not common in bulimia, it may go up and down, but it often remains ‘normal’.  It’s important to note that a person can have an eating disorder at any weight, they do not need to be underweight to be struggling.  Whilst bulimia is most common in young women, it can affect young men also and can affect people of all ages.

These are examples of behavioural traits in those with bulimia, however, if you are concerned it is important to seek out your GP for medical advice.

Common issues parents or carers may have to contend with 

Bulimia may begin as a coping strategy for stress, anxiety, loneliness or other worries. A young person may consider it as a comforter, helper or solution rather than as a problem itself. A person with bulimia may deny having a problem and not wish to accept help.  

Parents and carers will have to contend with psychological changes. Those with bulimia will be pre-occupied with food, causing them to have difficulties concentrating. They are likely to have a distorted perception of their body shape, coinciding with a lack of confidence and self-esteem. They may not wish to talk as openly and become secretive and seemingly more independent, distancing themselves from their parents or carers. This can make it difficult for parents or carers to approach the topic or offer support. 

Bulimia commonly coincides with depression and anxiety, as well as other mental disorders. This is difficult for a parent or carer and important to notice as they may exacerbate the eating problems. Being patient, understanding and supportive is key.  

How to support a child or young person with bulimia

Those with bulimia may experience  worry, fear and guilt. They may be struggling to start a conversation about their problem or lack confidence in doing so. Therefore, voicing your concerns may open the conversation for them, however, it is important to not force them to discuss it.  

It is not easy to talk to someone about bulimia. Think about picking a good time to chat, a time when there are no constraints or distractions. Talk about what you are worried about and be supportive, stating how much you want to help. 

It is important to be patient and supportive. They may not be willing to talk straight away, but it is good to open a door for them.  

What to say to schools and colleges

If a child or young person is restricting their own food intake this can translate to diminished levels of concentration within lessons, increased irritability with peers and school staff, and potentially increased social isolation, all of which can impact on their academic achievements.  Making schools and colleges aware of the situation will allow them to offer more support including potentially identifying a trusted member of staff that can check in with your child regularly.  If your child is undergoing treatment, your school or college can also liaise with the healthcare team to build a community of support around your child.

You can talk to the schools or colleges about removing stressors for the individual, this can include giving extensions on homework deadlines, and be patient when they feel anxious or overwhelmed.  

It is important to stay close to the school or college so you can continue to communicate with them so their staff can give you updates on your child’s behaviour in school.  

Transitioning to university may see established support systems disappear so discussing this ahead of the transition is helpful and may help you both agree a process where you can check in without your child feeling spied upon or that you don’t trust them.

What to say to siblings 

Siblings often feel left out due to the attention of their sibling. It is important to give the siblings time at home where the focus is not on the eating disorder and give them the space to spend time with the family and ask questions about the eating disorder.  

Some will require some information about bulimia, so they understand. As with yourself, it is important to talk to siblings about what and what not to say. Talk about comments on eating, weight or appearance, suggesting that these may be particularly sensitive for their sibling. They must understand what changes will occur in the household set up, for example, more focus on family mealtimes.  

All siblings argue and fight at times. There is a possibility that in an argument the sibling may feel they have said something which has caused the eating disorder. It is key to reassure them that eating disorders are complex and one comment will not have caused it. If they feel guilty you could help them talk to their sibling about this, or even write a note to them.  

One thing to be careful of is that siblings may struggle over their weight and eating due to the environment at home. Discussing thoughts and emotions with them during this time is important. It may be that, as their parent or carer, you are not the easiest person for them to speak to so identifying a trusted person, maybe an older friend, family member or counsellor, may be appropriate.  

What to say to extended family 

Talking to the extended family depends on how close they are to the individual with bulimia. If they regularly visit the house it is important to be aware. Before they arrive, they should be informed of potential mood swings and irrational behaviour. Additionally, as with siblings, it is key to tell them to avoid comments about appearance, food and weight. With all this information it is important to not scare them off and discuss that the more normal the environment the better for everyone.  

Support for parents and carers is important too, so if you feel you are struggling through this difficult time it may be good to speak to extended family. They can offer support for you, being someone to talk to who is outside of the situation.  You may also find support groups where you can share your experience openly with other parents and carers who have or are gone through similar process which may help you talk openly without fear of being shame or lack of understanding.

Additional support for parents and carers