Intervention to Help Someone with Bulimia Nervosa

Mary is a fictional character used to demonstrate how an intervention for bulimia nervosa works.

Bulimia Nervosa. Sometimes it takes an intervention to help someone with bulimia (binge eating and vomiting). More here.When we left Mary, she was in tears. She realized that she couldn't go on living the way she had been the past few months -- binge eating and vomiting, obsessing about food and her appearance, acting in ways that were harmful to her health.

Luckily for Mary, she wasn't the only one who had noticed that something was very wrong. Lisa, Mary's college roommate and closest friend, had been nursing suspicions for several months. Mary seemed different -- more withdrawn and secretive. She didn't know what was wrong, but she had a feeling that it might relate to food. She and Mary had always enjoyed going out to lunch together on Saturdays, but for the past few weeks, Mary had declined. She also noticed that Mary spent a great deal of time talking about food and what she ate.

With these vague concerns in mind, Lisa began reading up on eating disorders. What she discovered convinced her that Mary was suffering from bulimia.

Does Someone You Know Have Bulimia?

If you think someone you know may be suffering from bulimia, answer the following questions as honestly as you can.

First, think about her recent behavior in terms of food:

  • Has she declined the offer to share a meal together more often than she accepts?
  • When she does eat with you, does she avoid carbohydrates? Does she order only salads? Or nothing at all?
  • Does she drink many glasses of water (to help the food come up more easily)?
  • Does she disappear into the bathroom after eating and stay a long time?
  • Does she flush the toilet more than once or twice?
  • If she uses the bathroom at your house, does she run the water?

Think about her conversation:

  • Does she talk about food all the time?
  • Is she preoccupied with weight -- hers and others?

Think about her appearance:

  • Was she recently slightly overweight -- just 5 - 10 pounds?
  • Has she recently lost weight?
  • Are her eyes bloodshot? Watery?
  • Does she have sores on her knuckles from inducing vomiting?
  • Is her voice hoarse?
  • Does she constantly have cold-like symptoms, such as sneezing, coughing, sniffling?
  • Does she have broken capillaries on her face?
  • Is her face puffy?
  • Do you notice small swellings in her cheeks, about the size of golf balls? (These are enlarged salivary glands.)

Think of your friend's general mood:

  • Has she been avoiding social occasions?
  • Does she seem especially secretive?
  • Is she drinking more than she used to?
  • Is she spending a lot of time at the gym, or compulsively exercising?
  • Does she seem moody? Depressed?
  • Is she habitually tired?
  • Has she stopped doing many of the activities she used to enjoy?

If the answer to many of these questions is Yes, then your friend may well have bulimia.

How Can I Help?

Understandably, Lisa felt shocked, saddened, and confused. She desperately wanted to help Mary, but wasn't sure how.

Fortunately, there is a technique that helps bulimics confront their problem and seek much-needed help. It's called an INTERVENTION.

Last Updated: 18 April 2016
Reviewed by Harry Croft, MD

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