Today we’re going to talk about a child who likely has bulimia and won’t talk to her mom. In my response, I’ll try to address the different aspects of the behavior that they’re describing and think about how we might interpret some of that behavior.
My daughter told her counselor at school that she’s been bingeing and purging. I think she picked it up from a lecture given during P.E. one day about eating disorders. I’m furious with the school and I’ve told them it’s irresponsible to teach kids how to binge and purge.
She’s always been such a good kid and she got good grades and excelled at everything she did. In fact, until now, I wanted my son to be more like her. But not anymore.
Now she refuses to eat with us or even sit with us. She goes for long periods of time, not talking to me, just completely ignoring me. I can hear her sneaking into the kitchen and then purging in the bathroom all night.
I’m at my wit’s end. What do I do?
Oh, Amala, I know how hard this is and I’m so sorry. There are a few things in your letter that I’m going to address to try and help you untangle some of what’s going on, how to interpret her behavior, and also some steps you could take to move forward.
Eating disorder origin
First, let’s talk about the origin of the eating disorder. I can understand why it seems like she picked up the eating disorder after that lecture. That makes a lot of sense. And there may have been some problematic language in the lecture.
I’d like to think the best of the school, but I do know that eating disorders are deeply misunderstood and well-meaning adults frequently make mistakes in their comments and discussions about them.
Also, you’re not the first parent to tell me this story, particularly with bulimia. I have heard from several parents who suggest that a school presentation was the impetus for the disorder.
But here’s an important thing. Your child would not have picked up the eating disorder unless there was something else going on.
Eating disorders can look like they come out of nowhere. They seem like they might start overnight.
And after all, there is always the first purge. And that can seem like it’s based on a thoughtless comment made during the lecture.
But we have to remember that there are a lot of ways that kids respond to information about purging, and the majority of kids who hear about it do not try it. And out of those who try it, only a small fraction continue with it at the level you’re describing.
Bulimia is a very serious eating disorder that requires specialized treatment. And while, of course, I can’t make a diagnosis, I think it’s pretty clear that your daughter is at least on the path, if not fully, in bulimia.
Now, typically, when someone sees a person has bulimia, they’re most concerned about the binge eating. But what they’re upset about is the purging.
And I do take that very seriously, of course.
But what I’m even more concerned about is what is going on that made her feel like bingeing and purging was the best way to get out of her pain. Because bulimia is a coping method. It’s a way to process emotional pain.
Of course, it’s complicated because we do live in a diet culture that is focused on the thin ideal. And bulimia as an eating disorder is often wrapped up in the desire to be thin and eating disorder.
Treatment addresses that desire, that demand for thinness or control over food. But what we know is that underlying the obsession with body and food is usually unmet emotional needs and a child who’s simply trying to feel OK.
Eating disorders are so much more than a diet and they’re definitely not something that should be dismissed as sort of a silly teenage thing that girls go through. They are far more serious.
A trained therapist can help find out what is she in pain about. Why is she using bulimia as a coping method? And then a therapist will help her gain new coping methods so that she no longer needs bulimia to feel OK.
Meanwhile, while she is getting treated, you parents can learn more about eating disorders and create a pro-recovery home environment.
When good girls get bulimia
Next, you mentioned that she’s always been a good kid and this actually may give us a glimpse of where the bulimia came from.
You see, no child is all good.
All human beings are complex and multifaceted. Sometimes a child will present a single facet of their self to the world because they feel ashamed of their darkness, their shadow.
These children develop the belief that other people will only love them if they’re good, if they get good grades, if they look attractive, if they stay thin, do well in sports … you get the idea.
When we see a child who is consistently defined as good, I’m wondering what she does with her badness. Because a child who always appears good is hiding her full self from the world.
This is extremely distressing. Living is just a part of yourself creates tremendous emotional pain. Because to be known, fully known is how we feel loved.
So a child who has developed the persona of being good might be someone who doesn’t believe she can be both known and loved.
And to be clear, this doesn’t happen on purpose and it’s nobody’s fault. It’s a gradual development that comes from the combination of the child’s genetics, inborn temperament, their developing personality, and how these things interact with the child’s environment.
But what a therapist will be looking for when a “good” child develops bulimia is how to make it safe for her to unlock her full self so that she doesn’t have to let it out in secret when she’s all alone.
While she does this work in therapy, you parents can learn to make adjustments to your own behavior to make it safe for the full child to emerge and feel loved as fully human, meaning imperfect.
Withdrawal during bulimia
The last point I want to address is her withdrawal from you and your family activities.
I know she’s not verbally communicating, but her behavior is a very clear communication that she needs help. In fact, sometimes I think that the silent child is the loudest child if we truly listen. When a child with bulimia won’t talk to mom, it’s deeply painful for everyone.
We have to interpret her communication as best we can and get her some help right away. The first thing I recommend is that you schedule an appointment for her to meet with an eating disorder therapist.
This really needs to be someone who has direct experience and supervision, working with teens who have eating disorders. I don’t recommend a general therapist. It can actually be a little risky in these situations.
When someone has an eating disorder at the level you’re describing, you really do need a specialist.
Your daughter needs specialized help as quickly as you can get it. So I recommend you get her in to see a therapist as soon as possible.
Learning new skills
Meanwhile, you parents can get started on your work.
I would begin by learning more about eating disorders and getting some coaching or therapy for yourselves to better understand what’s going on.
I think there may be room in your family for some new communication skills, particularly when it comes to communicating feelings. Parents who learn these communication skills can create a healing home environment that is peaceful and loving for everyone. In this environment, a child is more likely to recover.
But please remember, your daughter needs help that you cannot provide alone.
You can help her recover, but she needs professionals, too.
Amala, I hope this has been helpful. I know how scary this is and I send you all so much love as you move forward.
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