Bulimia & Anemia 

Bulimia nervosa (BN) and anemia are often linked, with an estimated overlap rate of more than 11%. [1]

The disordered eating and behavioral patterns associated with bulimia nervosa can cause the body to become deficient in a variety of necessary vitamins and minerals. When the condition leads to a low iron count, it can lead to anemia.

Anemia issues from bulimia

What Is Anemia?

One of the blood’s primary purposes in the body is to carry oxygen from the lungs to everywhere else. In order to do this, the body needs a type of protein called hemoglobin.

Building this protein is a very iron-intensive process, so a lack of the mineral can lead to less hemoglobin in the blood. When levels are low enough that the blood can no longer successfully carry oxygen supplies, it’s called anemia. 

A lack of iron can also lead to low red blood cell counts, which has also been noted in many people who struggle with bulimia nervosa. [2]

Signs of Anemia

Anemia may show up as a number of signs and symptoms, including: [3]

  • Fatigue
  • Feeling cold
  • Dizziness
  • Irritability
  • Headache
  • Shortness of breath

Anemia is diagnosed through a blood test and physical exam. Treatment depends on the severity and type of anemia that is present.

How Can Bulimia Lead to Anemia?

Eating disorders such as bulimia nervosa can cause the body to become deficient in many essential nutrients, vitamins, and minerals. This can be due to not eating enough, not eating the right types of foods, or purging food before the body has a chance to properly digest. 

Iron is a mineral found in green leafy vegetables and red meat. When these types of foods are limited, or purging takes place before they can be absorbed, it can lead to a shortage of the mineral in the blood. 

The process of binging and purging that characterizes bulimia nervosa can also impact the endocrine system of the body or the system in charge of creating and distributing hormones. 

The regulation of hormones is a delicate and intricate process, and the disruption of this system can lead to many complications in the body, including trouble producing hemoglobin.

What Other Circulatory Issues Can Occur With Bulimia?

Bulimia nervosa has been linked to a number of circulatory and cardiovascular complications.

Women with bulimia have a higher risk of being hospitalized for cardiovascular disease.

Purging—and, particularly, self-induced vomiting—works to deplete the body of important electrolytes. These minerals essentially keep the electronics in the body running smoothly. When their levels are disrupted, it can lead to issues with the electric signals that keep the heart beating at a steady pace. 

Electrolyte imbalance caused by purging can lead to arrhythmia, low blood pressure, and a slowed heart rate. In severe cases, the issue can also contribute to major cardiovascular events, including heart failure. 

Unfortunately, the research bears this out, with studies showing that women with BN have a higher risk of being hospitalized for cardiovascular disease and death. [4]

Treating Bulimia Nervosa

Due to their complex nature, eating disorders often require comprehensive treatment plans. This type of care should address not just the physical complications but the psychological conditions contributing to or caused by the eating disorder. 

Treatment programs for BN include a variety of trained professionals who work together to treat all aspects of the eating disorder. In a comprehensive program, the following will be addressed:

  • Biological issues
  • Cultural forces
  • Psychological needs
  • Medical complications
  • Interpersonal issues

Treatment plans should be different for each person. They must be tailored to address individual needs and any other potential co-occurring medical and/or mental health conditions.

How to Find Bulimia Nervosa Treatment

Bulimia nervosa is a serious mental health condition that can lead to significant medical issues and even death if left untreated. It is important to get professional help as soon as possible. 

If you are concerned about an eating disorder, it’s important to talk to your doctor about your concerns and symptoms. Your doctor can make referrals and help you find professional treatment for BN while attending to any pressing medical needs. 

Treatment programs for eating disorders are often covered by medical insurance. Your insurance provider can be another source to help you locate programs.

And the National Eating Disorders Association (NEDA) operates a helpline that is available online, by phone, or via text, which can offer additional resources and information. 

The most important thing to remember is that help is out there. It may feel scary, but seeking proper care can be the first step toward a happier and healthier future.


  1. Walsh, K., Blalock, D. V., Mehler, P. (2020). Hematologic Findings in a Large Sample of Patients With Anorexia Nervosa and Bulimia Nervosa. American Journal of Hematology; 95(4):E98-101.
  2. Health Consequences. (2022). National Eating Disorders Association. Retrieved September 20, 2022.
  3. Anemia. (2016, July 29). U.S. National Library of Medicine. Retrieved September 20, 2022.
  4. Tith, R., Paradis, G., Potter, B., et al. (2019, October 16). Association of Bulimia Nervosa with Long-Term Risk of Cardiovascular Disease and Mortality Among Women. JAMA Psychiatry; 77(1):44-51.

Last Update | 01 - 9 - 2023

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