Monday, January 5, 2009

Bulimia

N is now 12 1/2 years old. When he first got anorexia, he was barely 11. At the beginning of his treatment, his therapist stated that it was good that N didn't also have bulimia -- that the characteristics N was demonstrating at the time were evidence that we would have a long, long road ahead if N's illness led him toward purging. Because of this concern, we've watched him carefully for signs of purging, kept the research books hidden (with mixed success), and haven't really talked in depth about bulimia. I assumed that N didn't really know what bulimia was and that to talk about it was to also put ideas in his head.

I briefly talked to N after our visit with his Great Grandmother (last post) and wondered whether it made him uncomfortable. You can imagine my surprise, though, when he shifted subjects and started talking about the girl with bulimia, confessing that he had "thought about it" (throwing up), but couldn't stand the idea of making his throat burn. I looked at my husband, who was also processing the comment in shock.

I'm not sure what to do with this information now. I think it was naive of me to think that by not talking about bulimia it could prevent N from purging. It leaves me wondering if we should have (or should be) engaging that topic more directly. Thankfully, though, I really believe him when he said that he has never done it.

7 comments:

Erica said...

My d picks up a lot of stuff from kids at school, so I'm not suprised that your s knows about bulimia. Luckily for us our daughter hates throwing up and can't even get thru a teeth cleaning at the dentist because she hates having things in her mouth and she gags.

I think I would be open and honest -- "some kids do this. Have you ever thought about doing it? What would happen? Could you tell us if you thought about doing it?" Stuff like that...

The fact that your son felt comfortable enough to mention this to you is a testament to how he has come through his ordeal!

Wendy said...

Thanks Erica -

How is your daughter doing?

Erica said...

Generally well, still lots of ed behavior -- balks at eating certain foods and we caught her hiding food again a couple weeks ago, but her mood has been great and the weight keeps coming on. I think we need to get another 5 lbs on her before things will really improve, although she will actually talk about her ed with us now and we are able to go away for a few days on family vacations.

I still get so confused by which behaviors are ed and which are just 11.5 year old girl starting puberty...she is starting to really sprout physically, so we have to be even more vigilant about getting her to eat enough!

Wendy said...

Erica -

That sure sounds a lot like N. I have a different son who is just about ready to turn 11. I've realized that I don't have any idea of what to expect from a healthy 11 year-old (because I couldn't seperate those behaviors either).

Anonymous said...

I sometimes wonder if more straightforward education about bulimia (in health class curricula, for example) would help head off some cases of this painful and debilitating disorder. If kids knew:

1. purging does not get rid of all the calories consumed during a binge. It's been examined in laboratory conditions (!) at the University of Pittsburgh and only about half of consumed calories are expelled.

2. purging (like starvation) reinforces bingeing and causes the disorder to deepen. Over time, people with bulimia tend to gain weight.

3. laxatives are not effective in preventing calorie absorption

4. purging can cause the esophagus to become inflamed and even rupture (rare, but potentially fatal.)

5. purging cause dental damage from stomach acid

6. purging can cause electrolyte imbalances resulting in heart irregularities or failure (rare, but life threatening.)

By the time the disorder is established this information might not be enough to halt it, but given early who knows?

Wendy said...

Thanks for all of these thoughts!

Erica said...

I am not a big fan of schools educating kids about nutrition and health, mainly because they often get it so wrong.

Last year my daughter's fifth grade spent a whole hour learning how to read a food label and how many calories they should be getting each day, and then they were asked to keep a food journal -- now for a normal kid this info will probably go in one ear and out the other, but for my disordered child it was information that helped feed her ed.