Managing Purging in a Teenager: A Guide for Parents

Purging—whether through vomiting, laxative use, excessive exercise, or fasting—is a serious and dangerous behavior associated with bulimia nervosa, binge-purge subtype anorexia, and other eating disorders. Helping a teen overcome purging requires compassion, medical and psychological intervention, and a structured recovery plan.

Why Do Teens Engage in Purging?

·         Emotional Triggers:

o   Anxiety, stress, or emotional distress

o   Feeling guilt or shame after eating

o   Fear of weight gain or loss of control

·         Disordered Thinking:

o   “If I purge, I can erase what I ate.”

o   “This is the only way to control my weight.”

o   “I don’t deserve food.”

·         Physical Urges:

o   Binge eating episodes followed by purging

o   Feeling overly full after a meal

·         Purging is not just about weight

o   It’s a coping mechanism.

o   Recovery means replacing purging with healthier ways to manage emotions

The Dangers of Purging

·         Serious Health Risks:

o   Electrolyte imbalances

§  Can lead to heart palpitations or cardiac arrest

o   Severe dehydration

§  Causes low blood pressure, dizziness, fainting

o   Esophagus and stomach damage              

§  Acid erosion, ulcers, and tears

o   Tooth decay 

§  Stomach acid wears down enamel

o   Intestinal and digestive issues

§  Laxative abuse damages normal bowel function

o   Purging is dangerous, even if your teen appears physically “fine.”

§  Long-term purging has life-threatening consequences.

How to Support a Teen Who Purges

·         Open the Conversation (Without Judgment)

o   Express concern calmly:

§  “I’ve noticed you seem really anxious after eating. Is something making meals hard for you?”

§  “I love you, and I want to understand what’s going on.”

§  “You don’t have to face this alone. We’re going to get through this together.”

o   Avoid blaming or shaming:

§  “Why are you doing this to yourself?” (Sounds accusatory)

§  “You’re just doing this for attention.” (Minimizes their struggle)

§  “You’re ruining your body.” (Focus on emotional support, not guilt)

o   Goal: Show love and concern, not punishment. Teens need to feel safe before they will open up.

·         Address the Underlying Causes

o   Identify Purging Triggers

§  Keep a “Mood & Meal” Journal to track when and why they feel the urge to purge.

§  Common triggers: feeling out of control, social anxiety, body image struggles, guilt after eating.

o   Replace Purging with Healthier Coping Mechanisms

§  Deep breathing exercises & mindfulness techniques

§  Journaling or talking about feelings instead of suppressing them

§  Engaging in non-food-related distractions (art, music, nature walks)

o   Work with a Therapist Specializing in Eating Disorders

§  Cognitive Behavioral Therapy (CBT-E) helps challenge purging thoughts and behaviors

§  Dialectical Behavior Therapy (DBT) helps with emotion regulation and impulse control

§  If your teen is resistant to therapy, normalize it as a tool, not a punishment:

·         “Therapy isn’t about fixing you. It’s about helping you feel better.”

·          Create a Safe, Structured Eating Environment

o   Set Regular, Balanced Meal Times

§  Prevents extreme hunger that leads to binge-purge cycles

§  Reduces anxiety around eating

o   Encourage Eating Together as a Family

§  Provides accountability and emotional support

o   Remove Access to Purging Opportunities

§  Limit bathroom use right after meals (engage in conversation or a family activity)

§  Keep track of laxative use—these should be medically supervised only

§  Watch for signs of over-exercising (compensatory behaviors)

§  Example Meal-Time Plan to Reduce Purging Urges:

·         Before Meals: Deep breathing, positive affirmations

·         During Meals: No distractions, structured conversation

·         After Meals: Engage in a non-food-related activity to distract from purging urges

·         Seek Professional Help (Medical & Psychological Support

o   Medical Monitoring

§  Doctors should check electrolyte levels, heart function, and dehydration risks

§  In severe cases, hospitalization may be needed to stabilize health

o   Therapy & Counseling

§  A therapist or psychologist will help break the binge-purge cycle

§  Family-Based Treatment (FBT) is the gold standard for adolescents.

o   Nutritional Support

§  A registered dietitian can create a structured meal plan to restore normal eating habits

o   ***If purging is frequent and severe, seek urgent medical attention. Electrolyte imbalances can be fatal.

Preventing Relapse & Long-Term Support

·         Monitor for Stress-Triggered Setbacks

o   School stress, social pressure, or body image concerns can cause relapse urges

o   Encourage healthy emotional outlets instead of turning to purging

·         Limit Social Media Exposure

o   Unfollow harmful diet culture pages

§  replace them with body-positive and recovery-focused accounts

o   Have open conversations about unrealistic beauty standards

·         Encourage Self-Worth Beyond Appearance

o   Praise their kindness, creativity, intelligence, and other non-physical traits

o   Support their hobbies and passions outside of food & body image

·         Recovery isn’t just about stopping purging—it’s about rebuilding confidence, emotional resilience, and a balanced relationship with food

Disclaimer: This information is intended for educational purposes and should not replace professional medical advice. If you or someone you know is in crisis or needs immediate help, please contact a healthcare professional or crisis intervention service immediately.