Bulimia Nervosa | Diagnosis & Treatment

How is bulimia nervosa diagnosed?

It can be hard to diagnose bulimia nervosa, since many adolescents with the disorder try to keep their illness very private and hidden. Parents, teachers, coaches or instructors may be able to identify a child or adolescent with bulimia, but the diagnosis is usually made by a qualified mental health professional or medical provider.

Since early treatment can often prevent future problems, if you note symptoms of bulimia in your child, it’s a good idea to seek evaluation and treatment sooner rather than later.

If an eating disorder is suspected, some components of the evaluation may include:

  • a careful patient and family history
  • physical examination
  • laboratory tests, including a complete blood count and a urinalysis
  • mental health and nutritional assessments

To help diagnose bulimia, your child’s doctor will:

  • assess weight changes
  • inquire about self-perceptions of weight and desired weight
  • ask your child about bingeing and out-of-control eating and purging
  • ask your child about use of laxatives and diet pills
  • ask your child about:
    •  abdominal pain
    •  bloating
    • constipation
    • hair loss or change in hair texture
    • cold intolerance
    • fatigue
    • weakness
    • fainting
    • substance use
    • sexuality
    • depression
    • amount of physical exercise
    •  stress fractures

Your child’s doctor will likely also conduct the following studies:

  • a social history — a review of risk factors focusing on the home, education and activities
  • a family history — information about conditions and disorders within the family, including eating disorders, obesity, alcoholism, depression or other mental illness
  • a physical exam — a clinician will assess and examine your child’s blood pressure, pulse, temperature, weight and height, skin and hair changes, heart function and abdomen.

What are the treatment options for bulimia nervosa?

Bulimia nervosa is usually treated with a combination of:

  • individual therapy (usually including both cognitive and behavioral techniques)
  • family therapy
  • nutritional rehabilitation
  • behavior modification
  • psychopharmacologic treatment

It's important to remember that family members play a vital supportive role in any treatment process. 

If your child becomes really sick — the condition gets worse, causing unstable vital signs, for example — they will be admitted to the hospital. Inpatients are placed on a "Restrictive Eating" clinical practice guideline. This means they meet with the same types of caregivers as an outpatient would, while participating in a special meal plan with customized weight gain goals.