bulimia eating disorder

Bulimia Eating Disorder Intervention: When and How to Do It

Eating disorders affect 9 percent of the population or 28.8 million Americans. Bulimia, in particular, affects 1.2 percent of adults in the country. Nearly 3 percent of people with bulimia have the disorder for life.

If anyone you care for has symptoms of bulimia, you may be able to change their lives for the better by intervening at the right time and convincing them to seek treatment for their eating disorder. People with eating disorders are sensitive about their condition and many will lash out or deny their condition when asked. Eating disorder intervention, therefore, takes finesse and genuine care and concern for the person you suspect of having the disorder.

So how should you help someone with bulimia? When and how should you do it? We offer some tips in this article.

Recognizing People with Bulimia

The best time for bulimic intervention is as early as possible. If you suspect that a loved one has bulimia, you need to verify if your suspicions are correct.

There are two types of bulimia that are medically recognized: binge-eating and bulimia nervosa.

Binge-eating is exactly how it sounds: people who develop this disorder have recurring binge eating “episodes” during which they cannot control the urge to eat. They become very distressed about these episodes, but they don’t go through a “purging” phase. This is explains the prevalence of obesity among people with binge-eating disorder.

Purging or throwing up the food you eat is distinctive to bulimia nervosa. People with this disorder also go through a period of excessive exercising or fasting after each binge-eating episode. This is because they feel  immense guilt while and after binge-eating, and they want to make up for their excessive consumption by drastically cutting their diet.

If your loved one’s behavior matches these tendencies, they might indeed need treatment for bulimia.

Other Signs of Bulimia


Besides binge-eating and subsequent fasting and exercising, here are other signs to watch out for:

  • Discolored teeth
  • Frequent bouts of sore throat, stomach pains, and diarrhea
  • Significant weight loss and/or fluctuating weight
  • Making excuses to skip meals
  • Obsessively counting calories and taking diet pills
  • Eating only small portions
  • Eating excessively when stressed, bored, or anxious
  • Hiding stashes of high-calorie food
  • Taking showers after eating (running water hides retching sounds)
  • Obsessively using mints and mouthwash (to hide the smell that comes with vomiting)
  • Wears loose clothes to conceal their body shape and weight
  • Large quantities of food mysteriously disappear from the fridge or pantry

A person with these physical symptoms and behaviors very likely have the eating disorder.

Approaching a Person Suffering from Bulimia

The next part is the most difficult: talking to the person whom you suspect of having bulimia.

There’s no one sure way to initiate an intervention, although we discourage highly-charged, emotional confrontations. Instead of feeling supported and cared for, the person might feel attacked instead and refuse any help with their bulimia.

A few more things to think about:

  • Make it a private conversation if possible. Although it’s good to involve the family, “airing out dirty laundry” before a crowd, no matter how well-meaning, will be unwise. The person you want to help might feel embarrassed, terrified, and worse, harassed.
  • Avoid having an aggressive, accusatory tone and “you” statements like “You’re not eating!” or “You look unhealthy!” The person might become defensive and resist your support.
  • Be specific and talk about the behaviors and symptoms you observed.
  • Make it clear that you’re not ashamed of the person, but that you’re willing to help them get better. Likewise, help them understand that they should not feel ashamed, and that there are others like them who overcame bulimia and got well.
  • Ask about their feelings and focus on that instead of how they are with food (bulimia is often a response to another issue, like sadness or anxiety).
  • Never make promises you cannot fulfill, especially if the person asks you to keep their disorder a secret (you may have to inform their guardians and family if their disorder gets worse and their life is in danger).
  • Don’t say, “Just stop,” and avoid commenting about their weight.
  • Show that you care, but make the person realize that they must be responsible for their actions.
  • Not all interventions succeed at once. Family members and friends may have to keep reassuring and encouraging their loved ones to seek treatment. It can take days, weeks, even months before a loved one will agree to seeing a psychiatrist. In some cases, however, you cannot afford to wait for the person to be “ready” for treatment, i.e., they are in poor health, in dire need of immediate treatment, and have a secondary condition like self-harm, drug abuse, depression, and suicidal tendencies.
  • Encourage them to seek professional help.

The Center for Cognitive and Behavioral Health can advise you further on how to stage an intervention on a friend or family who may be suffering from bulimia. If and when they’re ready to seek help, they are welcome to seek treatment from our psychiatrists.

Request an appointment today.