Any psychiatric disorder can disrupt a person’s well-being. Eating disorders, like bulimia, are especially destructive because they affect both emotional and physical health. Early intervention is critical because some long-term effects of bulimia can be permanent.

Bulimia nervosa is a type of eating disorder that involves binging and purging.

  • Binge eating – Involves eating large amounts of food, often high-calorie food
  • Purging – The elimination of the food from the body. Many bulimics use several purging behaviors that can include:
    • Self-induced forced vomiting
    • Fasting
    • The use of laxatives or diuretics
    • Exercising to exhaustion.

The binge-and-purge cycle leads to a wide range of health effects. These are due to malnutrition and dehydration, and the effects of purging. The effects of bulimia often take time to become noticeable. Over time they can become serious and even life-threatening.

Organ Health

Heart problems: The binge-and-purge cycle leads to dehydration and electrolyte imbalance. This is one of the riskiest effects of bulimia. Some electrolytes, including sodium and potassium, are essential for maintaining heart rhythm. An imbalance in electrolytes can lead to a dangerous, even fatal heart arrhythmia.

Kidney damage: Chronic dehydration and malnutrition take a serious toll on the kidneys. Bulimia leads to an increased risk of kidney stones and long-term kidney damage. In some cases, the damage is severe enough to need dialysis or a kidney transplant.

Pancreatitis: The pancreas secretes insulin, digestive enzymes and hormones. In bulimia, the pancreas can become inflamed because of binging and diuretic abuse. This causes:

  • Fever
  • Chills
  • Nausea and vomiting
  • Rapid heart rate
  • Abdominal pain

Pancreatitis can be life-threatening. It develops quickly and requires immediate medical attention.

Gastrointestinal Health

Acid reflux: This common bulimia side effect happens because of frequent purging. Purging weakens the muscles that keep the opening to the stomach closed. Partially digested food mixed with stomach acid gets pushed back up through the esophagus.

Chronic acid reflux is called gastroesophageal reflux disease (GERD). Risks of GERD include esophageal inflammation and abnormal narrowing of the esophagus. It can also lead to a pre-cancerous condition called Barrett’s esophagus. GERD may also increase the risk of the rare cancer esophageal adenocarcinoma.3

Chronic constipation: Long-term abuse of laxatives can damage nerve endings in bowel muscles. This makes it difficult to have normal bowel movements, even if you stop using laxatives. Constipation is a long-term bulimia side effect that can keep happening even after recovery.

Hemorrhoids: Laxative abuse causes frequent, rapid bowel movements that damage blood vessels in the anus. This leads to the formation of external or internal hemorrhoids. A mild case of hemorrhoids can be treated with over-the-counter remedies. Severe hemorrhoids may need prescription treatment or surgery.

Ruptured stomach or esophagus: Binge eating stretches the stomach beyond its normal volume. The stomach can become so weak that it ruptures, spilling stomach acids into the body. A rupture is rare, but life-threatening.

Repeated vomiting can lead the esophagus to tear. The first tears are small, with the only sign being blood in the vomit. If the esophagus is severely weakened, it can rupture much more. Like a gastric rupture, this can be fatal. Both kinds of rupture need immediate medical attention.

Oral Health

Swollen cheeks: Chronic vomiting can cause swelling of the salivary glands. This causes puffy swelling around the cheeks and jawline. The swelling usually subsides when the bulimic enters recovery, but it can take weeks or months for the puffiness to disappear completely.

Tooth decay: Chronic vomiting erodes tooth enamel, increasing the risk of tooth decay. Many people with bulimia also produce less saliva, which further increases the risk of tooth decay. You also have a high risk of swollen gums and gum disease. A dentist can repair the damage, but it may involve costly dental work to be done.

Female Health

Irregular or absent periods: When the body is malnourished, the brain shuts down non-essential functions. This lets your crucial organs get the nutrients they need to survive, but other things stop. Menstruation ceases in up to 50% of bulimic women. Others have irregular or lighter periods.5

Bulimia in pregnancy: Women who binge eat and purge during pregnancy risk complications. These include:

  • High blood pressure
  • Gestational diabetes
  • Miscarriage

After birth, there’s a risk of breastfeeding problems and postpartum depression. Risks to babies include:

  • Low birth weight
  • Birth defects
  • Stillbirth

General Health

Muscle fatigue: When you’re malnourished, your body tissues don’t get the nutrients they need to maintain themselves. This leads to aching joints and muscles. Once you maintain a healthy diet, this side effect should stop.

Bone health: Malnutrition may lead to a calcium or phosphorous deficiency. This can have long-term consequences for bone health. Bulimics—especially women—are at risk of osteoporosis due to loss of bone density.

Hair, skin and nails: No part of your body is immune to malnutrition or dehydration. Bulimia can lead to:

  • Hair loss
  • Brittle nails
  • Rough or scaly skin

Mental Health

Like anorexia nervosa, bulimia doesn’t have one single cause. Causes of bulimia are often specific to the individual. Low self-esteem, worries about weight management, and poor body image are important risk factors. Some people find that binging and purging helps them cope with anxiety or stress. Others use bulimic behavior to cope with trauma.

The causes of bulimia are psychological rather than physical. Bulimia can also have serious consequences for your mental health. The binge-and-purge cycle of bulimia reinforces your negative feelings. It also reinforces the use of disordered behavior to control stress. Some people with bulimia become obsessed with monitoring their food intake or weight.

Bulimia can contribute to the development of co-occurring disorders. These can include depression, anxiety disorder or obsessive-compulsive behavior. Some bulimics abuse alcohol or drugs, while others self-harm or have suicidal thoughts or behaviors.

Gaining Weight in Recovery

One function of metabolism is to protect the body from malnutrition by conserving energy. Bulimics may eat thousands of calories in an hour but purge the food before their bodies absorb it all. This deprives them of key nutrients. As a result, the body goes into starvation mode, which slows metabolism.

The body often continues to conserve calories during recovery. Ceasing purging behaviors sometimes results in short-term or long-term weight gain. This is stressful for people with disordered eating, who often fear gaining weight. Even a small weight gain can trigger a relapse in a recovering bulimic.

Don’t Wait to Get Help for Bulimia

Eating disorders are hard on the body and mind. If you have bulimia, you risk serious and sometimes life-threatening side effects. It’s critical to seek treatment to prevent severe health problems. Proper treatment is the best way to overcome the challenges and effects that bulimia has on your body. Eating disorder treatment centers can provide a safe place in which to focus on recovery.

The Ranch Eating Disorder Program treats people with all kinds of eating disorders. At The Ranch, you’ll find a nurturing, non-judgmental place for a safe recovery. You’ll work with a team of compassionate professionals to recover from bulimia.

If you or a loved one is suffering from bulimia, get help now. Call The Ranch today at 844-876-7680.

Krisi Herron

Medically Reviewed by

Krisi Herron, LCDC

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