Bulimia nervosa (BN) has a mortality rate of around 4%, including an elevated risk of suicide.2 This eating disorder can also contribute to a number of dangerous health issues, including heart complications and esophageal cancer.
With early intervention and treatment, it is possible to prevent and reverse damage before it becomes too severe.
How Does Bulimia Harm the Body?
Bulimia nervosa is marked by cycles of bingeing and purging. People who struggle with this disorder will experience episodes where they eat large amounts of food within relatively short periods of time (like those with binge eating disorder), then later attempt to compensate for those episodes with some form of purging behavior.
Purging-type bulimia entails using self-induced vomiting or laxatives to expel food from the body. Those who struggle with bulimia may also participate in non-purging behavior, which involves compensating for binge eating habits with exercise or limited food intake.
In either case, these patterns can have devastating effects on the body and can lead to several medical complications.
Bulimia and Health Complications
Whether someone struggles with purging-type or non-purging-type bulimia nervosa, it can have a serious impact on their health.
Limited or disrupted food intake can significantly reduce the nutrients, minerals, and vitamins the body absorbs. This can cause a number of complications to all organ systems and severely impair the body’s ability to function correctly.
Not getting enough energy and nutrients from food can also leave a person physically weaker and more vulnerable to sickness. Someone struggling with bulimia may have a reduced ability to heal and a compromised immune system, which can also indirectly contribute to serious health problems.
Bulimia and Cardiovascular Complications
Many eating disorders, including bulimia, are associated with cardiovascular complications.
Calorie restriction, laxative and diuretic abuse, and overexercising can all put undue strain on the heart muscle and lead to cardiovascular issues.3 But perhaps the most significant contributor to heart health complications is bulimia’s impact on electrolyte levels in the body.
These essential minerals play a vital role in maintaining proper body functioning—including those that help keep the heart beating. An imbalance of electrolyte levels could confuse these electric signals, leading to irregular heart rhythms and potential cardiac arrest.
Bulimia and Digestive Health Complications
For those who experience purging-type bulimia nervosa, the effects on digestive health can be particularly severe.
One of the most significant complications is the effect repeated self-induced vomiting can have on the throat and esophagus. Repeated exposure to stomach acid can cause strictures and ulcers in sensitive esophageal tissue, making it difficult or painful to speak or swallow food. In serious cases, the esophagus may tear, which can be a life-threatening issue if not treated quickly.
Bulimia’s effect on the throat has also been connected to gastroesophageal reflux disease (GERD).4 This chronic condition can feel a lot like acid reflux or heartburn. GERD is caused when stomach acid or bile flows back up into the esophagus.
Bulimia and Oral Health Complications
Self-induced vomiting can also have a significant impact on a person’s oral health.5
Regular contact with stomach acid or bile can cause tooth decay, erosion, and tooth pain. This can then lead to changes in a person’s bite, due to weakening or rotting teeth or a weakened jawbone. Tickling fingers into the mouth and throat can also result in damage to the delicate tissue inside the mouth.
In severe cases, a person’s parotid glands—the salivary glands located just below the ears—can swell, potentially shifting their jaw painfully and in a way that sometimes requires surgery to fully correct. This can result in a condition called bulimia cheeks.
Life-Threatening Complications of Bulimia
Aside from the many negative impacts bulimia nervosa can have on someone’s physical health, the condition can also lead to deadly health complications.
Physical Health Complications
One notable life-threatening complication associated with bulimia is esophageal cancer. Damage caused by repeated self-induced vomiting can lead to the development of cancerous cells in the throat.6 Esophageal cancer can be deadly if not caught early.
Because of poor nutritional intake, people with bulimia nervosa are also at a higher risk of developing metabolic abnormalities.7 These conditions impact the way the body converts food into energy and, when disrupted, can have significant impacts.
It’s possible for someone struggling with BN to develop severe hypokalemia, or severely low potassium levels, eventually. This condition can cause a cascade of health issues, including potentially fatal episodes of muscle weakness or paralysis of key respiratory muscles.8
Mental Health Complications
While bulimia nervosa has a significant physical impact, the condition is still a mental health disorder that can lead to severe mental health issues.
It’s very common for people who struggle with bulimia nervosa to experience co-occurring mood disorders, especially depression and anxiety disorders.
Low self-esteem, poor body image, and other negative thoughts often accompany the disorder.
This combination of factors can be very dangerous and, unfortunately, deadly. People who struggle with bulimia have been found to have elevated rates of suicidal ideation and are seven times more likely to die by suicide.2,9
Can You Reverse the Harm Caused by Bulimia?
Fortunately, much of the harm bulimia can do can be reversed with proper treatment.
Reducing or eliminating purging behavior alone can help put a stop to some of the damaging effects the disorder has on the body. And working to improve nutritional intake can provide a further boost to both physical and mental health, balancing levels of essential fluids and chemicals and restoring the body to normal functioning.
Working with a trained professional can also help restore mental health by improving self-esteem, self-image, and a person’s relationship with food.
Some damage may require more intense or invasive treatments, including surgery. The longer someone has struggled with disordered eating behavior, the more severe the impact on their health will generally be. And it’s not always possible to undo all the harm this disorder can cause. That’s why it’s important to seek help as soon as possible.
Within Health offers personalized remote eating disorder treatment backed by years of experience.
Within’s IOP and PHP programs offer meal kit deliveries, a numberless scale, a convenient app to attend therapy sessions and view your schedule, and so much more.
Call for a free consultation
When and Where to Seek Help for Bulimia
The earlier someone gets help, the better their chances of reversing the damage bulimia can do and recovering fully. Because eating disorders are so complex and can cause serious, sometimes fatal, harm, a multidisciplinary approach to treatment with mental health professionals who are trained to treat eating disorders is most effective.
A comprehensive treatment plan for bulimia can include medical supervision, nutritional therapy, psychological therapy, alternative therapies, and support groups for those who are struggling and their parents.
Recognizing there’s a problem and asking for help are not easy. It can start with reaching out to a trusted friend, loved one, or healthcare provider. You can also contact local and national resources for eating disorders.
It can feel overwhelming, but help is always available. And recovery from bulimia and other eating disorders is possible.
Resources
- Arcelus, Jon et al. (2011). “Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies.” Archives of General Psychiatry; 68(7):724-31.
- Crow SJ, Peterson CB, Swanson SA, Raymond NC, Specker S, Eckert ED, Mitchell JE. (2009). Increased mortality in bulimia nervosa and other eating disorders. The American Journal of Psychiatry; 166(12):1342–1346.
- Bretz WA. (2002). Oral profiles of bulimic women: Diagnosis and management. What is the evidence? The Journal of Evidence-Based Dental Practice; 2(4):267–272.
- Sardar MR, Greway A, DeAngelis M, Tysko EO, Lehmann S, Wohlstetter M, & Patel R. (2015). Cardiovascular Impact of Eating Disorders in Adults: A Single Center Experience and Literature Review. Heart Views; 16(3):88–92.
- Denholm M, Jankowski J. (2011, February 1). Gastroesophageal Reflux Disease and Bulimia Nervosa – A Review of the Literature. Diseases of the Esophagus; 24(2):79-85.
- Brewster DH, Nowell SL, & Clark DN. (2015). Risk of oesophageal cancer among patients previously hospitalised with eating disorders. Cancer Epidemiology; 39(3):313–320.
- Zepf B. (2004). Metabolic Abnormalities in Bulimia Nervosa. American Family Physician; 69(6):1530-1532.
- Castro D, Sharma S. (2022, September 12). Hypokalemia. StatPearls. Accessed September 17, 2022.
- Smith AR, Zuromski KL, & Dodd DR. (2018). Eating disorders and suicidality: what we know, what we don’t know, and suggestions for future research. Current Opinion in Psychology; 22:63–67.