How to Talk with our Teens About Bulimia

Talking to a teen about bulimia can be challenging, as parents, teachers, coaches, or friends may not exactly know what to say about bulimia or how to say it in a way that feels supportive to the teen.

We may need to talk with our teens about bulimia for various reasons — perhaps they come to you for support with bulimia or perhaps you are concerned they may be struggling with bulimia. Other conversations may be guided by the goal of helping the teen pursue treatment.

In any of these scenarios, an emotionally charged discussion is often anticipated. Being prepared can allow this conversation to go more smoothly.

Here are five tips when talking to a teen about bulimia:

1. Help educate and build awareness. Understand that the teen may not be fully aware of what bulimia is and why it’s a cause for concern. Gather resources and have them available when you approach the teen.

Any literature about bulimia, why it’s concerning, or where to go for help may help them identify that they are struggling. Also, in the case that they may have some awareness of their struggles, you are providing them with resources they may not know were available to them.

2. Be gentle and caring. Find a good time to talk to the teen. If you are discussing bulimia with a teen who may be struggling, be sure to speak to them privately and allow for adequate time to talk openly and honestly.

In a caring and non-confrontational way, communicate to the teen that you are concerned about them. Calmly tell them the specific observations that you have noticed and are a cause of your concern. Focus on eating or exercise behaviors that you have noticed or other concerns.

Some examples include withdrawing or isolating from others, seeming like they may be feeling down or stressed, food that you saw hidden in their room, or noises overheard from the bathroom. A good rule of thumb is to avoid using words that define physical appearance. Words such as “thin,” “skinny,” or “sickly” may unintentionally reinforce disordered eating patterns.

3. Actively listen. Allow the teen time to ask questions and respond. Listen carefully and in a nonjudgmental and open manner. Listening is very important in this process. Face the teen, maintain eye contact, and an open posture. Calmly answer what questions you can.

If you are expressing concern to the teen, avoid conflicts or a battle of wills with the teen. If they refuse to acknowledge that there is a problem or any reason for you to be concerned, restate your feelings and observations calmly and leave yourself open and available as a supportive listener.

4. Validate and restate. Summarize what you have heard them say and reflect that back to them their thoughts or feelings. For example, “You feel worried that your eating has become a problem.” Or, “You don’t feel like your eating or exercising is any cause for concern.”

This type of validation is a key to having the teen feel understood and willing to hear you out. If you are still concerned about the teen after listening and validating, tell the teen that because of what you’ve observed, you think they may be struggling with eating, body image, or exercise.

Restate your concern about their health and well-being if needed. Explain that you believe these things may indicate that there could be a problem that needs professional attention. Ask the teen to explore these concerns with a therapist, doctor, or dietitian who is an expert in disordered eating.

5. Leave with an action step — get help and support. Have an action step in mind and share it with the teen. If you feel comfortable doing so, offer to help the teen make an appointment or to accompany them on their first visit to an eating disorder expert.

Avoid placing shame, blame, or guilt on the teen regarding their actions or attitudes. Do not use accusatory “you” statements like, “You just need to eat normally.” Instead, use “I” statements. For example: “I’m concerned about you because you seem to be exercising a lot.” Or, “It makes me afraid to hear you vomiting.”

Avoid giving simple solutions. For example, “If you’d just stop, then everything would be fine!”

Know that you are not expected to have all the answers, and you can let the teen know that you’d like for the both of you to seek additional guidance from an eating disorder expert — for example, a therapist, physician, or dietitian who specializes in eating disorders in your area.

Problems that are particularly troubling and warrant immediately seeking help include: if the teen is binging and purging several times throughout the day, passes out or complains of chest pains, complains of severe stomachaches or vomiting blood, or has thoughts of harming themselves or suicide.

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Sources and Resources:

National Eating Disorders Association www.nationaleatingdisorders.org
Fielder-Jenks, Chelsea. (Feb 2, 2018). Thrive Counseling & Consulting Blog. NEDA Awareness Week: How to Help Someone with an Eating Disorder. Retrieved from: https://thrivecounselingaustin.com/blog/2018/2/27/neda-awareness-week-how-to-help-someone-with-an-eating-disorder

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About the Author:

Chelsea Fielder-Jenks is a Licensed Professional Counselor in private practice in Austin, Texas. Chelsea works with individuals, families, and groups primarily from a Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) framework.

She has extensive experience working with adolescents, families, and adults who struggle with eating, substance use, and various co-occurring mental health disorders. You can learn more about Chelsea and her private practice at ThriveCounselingAustin.com.

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The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on July 2, 2019,  on EatingDisorderHope.com
Reviewed & Approved on July 2, 2019, by Jacquelyn Ekern MS, LPC