9 Aug 2022


Bulimia in Adolescents: Causes, Symptoms, and Treatment

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Academic level: University

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Adolescents today are faced with several eating disorders. Bulimia, for instance, is a disorder in adolescents which involves uncontrolled episodes of binge eating followed by self-induced vomiting, misuse of enemas, laxatives or medications that leads to mass urine production, fasting or even excessive exercise-all to control body weight. There are several factors that contribute to adolescents turning to bulimia, although there are only a few common causes or trigger for it due to uniqueness of individuals. Developmental stages may also play a significant role in bulimia development, as will be discussed in this paper.

Common traits and factors that influence bulimia development include experiencing trauma, genetics, culture, personality and family. However, none of these factors gives a correct prediction of developing the disorder, although a combination of any of them may play active roles. Looking at genetics, some genetic traits are associated with certain behaviors. Some are associated with anxiety, mental disorders and depression (Trace, Baker, Peñas-Lledó & Bulik, 2013). Trauma, which can be due to death of loved ones or abuse, may trigger binging and purging. With the evolving mass media in communication and advertisements, culture has also given a direct linkage between skinny and beauty. According to a study by Harvard researchers on the diet habits of residents of Fiji highland, culture and media has played a very big role on how people perceive the body image.

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Human beings go through various developmental stages in their lives from birth to adulthood. These stages play roles in as far as eating disorders are concerned in individuals. Eric Erikson, in his psychoanalytic theory of psychological development posited that there are eight crucial stages from infancy to adulthood, whereby each stage is characterized by personal psychosocial crisis which may have either positive or negative result on personality development. The first five stages are included in the ages from birth to eighteen years while the other three comprise stages beyond 18 years, all through to adulthood.

The developmental stages as proposed by Erikson include Trust vs. Mistrust, Autonomy vs. Shame and Doubt, Initiative vs. Guilt, Industry(competence) vs. Inferiority, Identity vs. Role Confusion, Intimacy vs. Isolation, Generativity vs. Stagnation and Ego Integrity vs. Despair in that order. However, Identity vs. Role Confusion will be singled out for discussion in relation to the development of bulimia in adolescents.

Identity vs. Role Confusion, which is the fifth stage, occurs during adolescence for ages between 12 and 18. It is during this stage that adolescents have an insatiable desire to seek a sense of self and personal identity majorly through exploration of believes goals and personal values. Erikson contents that this transition period from childhood to adulthood is very crucial as children begin to have a sense of belonging and fitting to a society and also tend to assume different future roles (Darling-Fisher & Leidy, 2015). For instance, they would want to get into relationships, explore their careers and even think of getting successful families. In a nutshell, they want to learn their roles and positions to occupy when they grow into adults. At this stage, they will try as much as they can to re-examine their identity in finding out who exactly they are. This, according to Erikson, results into two identities, the occupational and sexual.As the stage ends; there will be a reintegrated sense of oneself, of future occupation, and of ones’s suitable sex role.

It is during this stage that the body image of the adolescents undergoes numerous changes, which they may not be comfortable with for some time but later adapt to them. Another alternative will be changing their eating habits which may induce disorders in them (Campbell & Peebles, 2014). The virtue of fidelity develops in them following successful completion of this sensitive stage. According to Erikson, fidelity here will mean that they will be able to commit themselves to other people on the basis of accepting them regardless of differences in ideologies which may be witnessed at times. Here, they explore as many possibilitie as they can and thereafter form their own identities with respect to the result of their explorations (Muller, 2014). Some will get to a point where they will not be able to identify with the society-uncertainties in knowing who they want to be in future, leading to role or identity confusion. In other words, they are not sure about their place in the society.

When identity crisis or role confusion occurs, adolescents may respond by beginning to experiment with various lifestyles, for example education, political engagements or work. Now, that said, we can relate this identity recognition or lack of thereof, to developing bulimia. In trying to identify with the society, adolescents find themselves entangled in internal forces. For instance, when one wants to be a model, they engage in particular behaviors that will see them reduce their weight and maintain a particular body shape, leading to bulimia.

Society can also play part in bulimia development in adolescents. This can be explained by the social cognitive and behavioral theory, which is relevant to health communication. It focuses on cognitive, emotional and behavioral aspects in understanding change in behavior and gives insights for researching new behavior in health education (Young, Plotnikoff, Collins, Callister & Morgan, 2014). The theory tries to explain how individuals assimilate and maintain particular patterns of behavior.

Behavioral change can be brought about by environment, behavior and people. Environment will affect someone’s behavior. Further into the environment factor, there are both physical and social environments. The social environment includes friends, family members and colleagues while the physical environment may comprise availability of particular types of foods, room size or even temperature. Looking at the social environment, we can note that support or lack of it by family members or the society in general may greatly influence bulimia.

As adolescents search for identity, they may face high tension in conflicting forces, that is, the internal forces of one’s self and the society forces which are external. In exploring different roles or ideas, they may change their ideas about whomever it is they really want to become. Parents can play a big role here. Supporting these undecided adolescents by allowing them to experiment their roles is likely to see them end up with a cohesive and distinctive identity that expresses who they are.

On the other hand, if the family and the society offers no support and denies them the opportunity to experiment, then there is a possibility that they will end up in role or identity confusion. Also, lack of proper communication, improper expression of affection and emotions and emotional, physical or sexual abuse may lead to bulimia.

On the question of whether bulimia is gender selective, research has shown that it is more prevalent in ladies than in gents. According to the American Psychiatric Association (2013), bulimia affects 1-1.5 percent of females with a 10:1 ratio of females to men affected by this disorder. Other studies carried out by Steinberg, Phares and Thompson to determine how the risk factors for bulimia development differ between ladies and gents showed that females are at a higher risk since they have a tendency of thinking to lose their weights even at tender ages.

In conclusion, bulimia is a killer disorder which needs to be checked both at the family and society level. It majorly results from peer pressure and search for identity, which can be controlled with proper monitoring of the adolescents as they transit to adulthood.


Campbell, K., & Peebles, R. (2014) Eating disorders in children and adolescents: state of the art review. Pediatrics , 134 (3), 582-592.

Darling-Fisher, C., & Leidy, N. (2015) The Modified Erikson Psychosocial Stage Inventory

Muller, T. (2014) Identity formation and its role in optimal human development: a psychobiographical study of artist Jackson Pollock New Voices in Psychology , 10 (1), 3-15

Trace, S. E., Baker, J. H., Peñas-Lledó, E., & Bulik, C. M. (2013). The genetics of eating disorders Annual review of clinical psychology , 9 , 589-620

Young, M. D., Plotnikoff, R. C., Collins, C. E., Callister, R., & Morgan, P. J. (2014). Social cognitive theory and physical activity: a systematic review and meta ‐ analysis. Obesity Reviews , 15 (12), 983-995.

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StudyBounty. (2023, September 14). Bulimia in Adolescents: Causes, Symptoms, and Treatment.


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