BULIMIA NERVOSARECOGNISING THE WARNING SIGNS

Dr Pooky Knightsmith

WHAT IS AN EATING DISORDER?

Food and weight used as a way of copingSerious mental health issue

ANYONE can be affected

Not all about appearances

Low self-esteem

BULIMIA NERVOSA

I spent longer throwing up than eating. Every time I’d promise myself I’d stick to my diet this time, but I just

couldn’t do it.

• Roughly normal weight

• Frequent fluctuation in weight

• Influence of shape and weight

• Binge purge cycle

• Most common forms of purging are laxative abuse and vomiting

Strict dieting

Diet slips or difficult situation

arises

Binge eating

triggered

Purging to avoid weight gain

Feelings of shame and self-hatred

THE BINGE PURGE CYCLE

TRIGGERSFamily relationship difficulties

Peer relationship break up

Bullying

Trauma

Exposure via friends, family, media

Difficult times of year e.g. anniversaries

Exam pressure

Times of change (new school, parents split etc)

BULIMIA IS A SECRETIVE DISEASE

People with bulimia are often very ashamed of their illness and will work hard to conceal signs and symptoms

making it very difficult to spot.

An awareness of the warning signs on the next few slides may help you pick up a case early – which will maximise the chances of effective support and

complete recovery.

Bulimia Warning Signs

Weight FluctuationDue to the binge purge cycle

However, weight change is often not noticeable making this a hard illness to spot.

Bulimia Warning Signs

Callused KnucklesDue to repeated vomiting.

This sign is not always present but is often the most clear indicator of bulimia.

Bulimia Warning Signs

Chewing GumDrinking Water

As a food replacement when trying to restrict food intake To mask the smell of vomit after purging

Bulimia Warning Signs

Wearing ScarvesScarves will sometimes be warn to hide swollen glands / puffy face

caused by vomiting

Bulimia Warning Signs

Toilet after MealsCould be a sign of purging – either laxative abuse of vomiting

Bulimia Warning Signs

Tooth Decay & Sore ThroatAcid in vomit wears away teeth. Dentists often note erosion of

enamel on the inside of teeth of someone who vomits regularly.

Bulimia Warning Signs

Can’t focus on School WorkToo consumed with eating disordered thoughts

Bulimia Warning Signs

IsolationPeople suffering with eating disorders will often push away their

friends and find they have less in common with them than they used to.

Bulimia Warning Signs Summary

Weight Fluctuation

Chewing Gum/

Drinking Water

Toilet after meals

Secretive behaviour

Puffy Face Calussed Knuckles Sore Throat Tooth Decay

Can’t Focus on School

Work

Isolation / loss of friends

How to be

helpful

Listen

Be honest

Try to understand

Persevere & offer

support

Voice the difficulties

Remember the ‘real’

child

TREATMENT OPTIONS• Family supported in playing an

active, positive roleFamily Therapy

• Alters behaviour by altering way we think about food / weight

Cognitive Behavioural Therapy

(CBT)

• Talking therapy with the aim of developing a healthy dietDietary Counselling

• Explores life experiences and their impact on behaviour

Psychodynamic Therapy

• AntidepressantsMedication

Need more support?Dr Pooky Knightsmith specialises in mental health and emotional well-being in the school setting. She can provide training sessions or workshops for school staff, parents or students on a variety of topics, including self-harm and eating disorders.

For further information and free resources visit www.inourhands.com

Email: pooky@inourhands.com Twitter: @PookyH