When it comes to bulimia nervosa, studies have found the condition carries a mortality rate of around 4%, including an elevated risk of suicide.  And even when not resulting in death, the condition can contribute to a number of dangerous health issues, including heart complications and esophageal cancer.
Still, in some cases, it may be possible to stop the damage and reverse it before it gets too late.
How Does Bulimia Harm the Body?
Bulimia nervosa (BN) is marked by cycles of binging and purging. People who struggle with this disorder will experience episodes where they eat large amounts of food within relatively short periods of time, then later attempt to compensate for those episodes with some form of purging behavior.
People with BN may have “purging type” bulimia, where they utilize self-induced vomiting or laxatives to expel excess food from the body. They may also participate in “non-purging” behavior, which is the attempt to compensate for binges with exercise or limited food intake.
In either case, these patterns can have devastating effects on someone’s physical health.
Bulimia and Nutritional Health Complications
Whether someone struggles with purging-type or non-purging-type bulimia nervosa, it can have a serious impact on their nutritional health.
Limited or disrupted food intake can have an outsized effect on the nutrients, minerals, and vitamins available to the body. This could cause a number of complications, primarily related to the body’s ability to perform the processes it needs to function properly.
This type of imbalance can also leave a person physically weaker and more vulnerable to sickness. Someone struggling with BN may have a reduced ability to heal or a compromised immune system, which could also indirectly contribute to serious health problems.
Bulimia and Heart Health Complications
Many eating disorders are also associated with cardiovascular complications, and, sadly, bulimia nervosa is no exception.
Calorie restriction, laxative and diuretic abuse, and overexercising can all put undue strain on the heart muscle, potentially leading to cardiovascular issues.  But perhaps the most significant contributor to heart health complications is BN’s impact on electrolyte levels in the body.
These essential minerals play a vital role in keeping the electronics of the body in working order—including those that help keep the heart beating on time. 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).  This chronic condition can feel a lot like acid reflux or heartburn and is caused when stomach acid or bile flows back up into the food pipe.
Bulimia and Oral Health Complications
Self-induced vomiting can also have a significant impact on a person’s oral health. 
The regular contact with stomach acid or bile can cause:
- Tooth decay
- Tooth erosion
- Tooth pain
This can then lead to changes in a person’s bite, due to weakening or rotting teeth, a weakened jawbone, or complications caused by sticking fingers into the mouth and throat.
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.
Life-Threatening Complications of Bulimia
Aside from the many negative impacts bulimia nervosa can have on someone’s physical health, the condition has also been associated with a number of potentially deadly health complications.
Physical Health Complications
One notable life-threatening complication associated with bulimia is esophageal cancer. One study found that the damage caused by repeated self-induced vomiting could lead to the development of cancerous cells in the throat.  Sadly, esophageal cancer is a very serious diagnosis, especially if not caught early.
Because of their generally poor nutritional intake, people with bulimia nervosa are also at a higher risk of developing metabolic abnormalities.  These conditions impact the way the body converts food into energy, and when disrupted, they can have significant impacts.
It’s possible for someone struggling with BN to eventually develop severe hypokalemia or severely low potassium levels. This condition can cause a cascade of health issues, including potentially fatal episodes of muscle weakness or paralysis of key respiratory muscles. 
Mental Health Complications
While bulimia nervosa has a significant physical impact, the condition is still a mental health disorder. As such, BN can also frequently lead to severe mental health issues.
It’s very common for people who struggle with bulimia nervosa to experience co-occurring mood disorders. Depression and a number of anxiety disorders are particularly common in people with BN.
These conditions contribute to other mental aspects of bulimia nervosa, notably the low self-esteem, poor body image, and other negative thoughts that often accompany and drive the disorder.
This combination of factors can be very dangerous and, unfortunately, sometimes also deadly. People who struggle with bulimia have been found to have elevated rates of suicidal ideation, and people who struggle with the condition are sadly seven times more likely to die by suicide. [1,9]
Can You Reverse the Harm Caused by Bulimia?
Fortunately, a significant amount of the harm done by bulimia nervosa can be reversed if a person seeks and successfully participates in treatment.
Reducing or eliminating purging behavior alone can help put a stop to a number 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, helping to balance levels of essential fluids and chemicals and restoring the body to normal functioning.
Working with a trained professional can also help ease the difficult mental health impacts of the condition. Many types of treatment exist that have been found to help patients improve their self-esteem, self-image, and their relationship with food. The effect can have a large positive impact on overall mental health and quality of life.
Still, it may not always be possible to undo all the harm caused by the disorder.
Some damage may take time to fix or 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. That’s why it’s important to seek help as soon as possible.
Where to Seek Help for Bulimia
Therapy can help you identify factors that contribute to your disordered eating behavior and develop coping mechanisms to help you deal with triggers in a healthier manner.
You can find support through local and national resources. For example, the National Eating Disorders Association’s Helpline offers a wonderful network of knowledgeable volunteers who can answer questions and give you information on eating disorder treatment resources.
You can call them at 1-800-931-2237, text them at 1-800-931-2237, or use their online chat feature through their website. 
But regardless of where you look for help, the most important thing is to remember that it’s always available. Recovery may seem difficult, but it can help lead to a longer life and a happier, healthier future.
- Crow, S. J., Peterson, C. B., Swanson, S. A., Raymond, N. C., Specker, S., Eckert, E. D., Mitchell, J. E. (2009). Increased mortality in bulimia nervosa and other eating disorders. The American Journal of Psychiatry; 166(12):1342–1346.
- Sardar, M. R., Greway, A., DeAngelis, M., Tysko, E. O., 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.
- Bretz W. A. (2002). Oral profiles of bulimic women: Diagnosis and management. What is the evidence? The Journal of Evidence-Based Dental Practice; 2(4):267–272.
- 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, D. H., Nowell, S. L., & Clark, D. N. (2015). Risk of oesophageal cancer among patients previously hospitalised with eating disorder. 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. Retrieved September 17, 2022.
- Contact the Helpline. National Eating Disorders Association. Retrieved September 17, 2022.
- Smith, A. R., Zuromski, K. L., & Dodd, D. R. (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.