In the worst cases, BN has the potential to cause life-threatening, even fatal, cardiovascular issues, including cardiac arrest and stroke.
Often, the effects of bulimia nervosa on the heart can be reversed or improved as the eating disorder itself is treated. In cases where damage may be permanent, treatment for bulimia nervosa will still help ensure these cardiovascular disorders don’t get worse.
How Does Bulimia Contribute to Heart Problems?
Broadly speaking, eating disorders can wreak havoc on someone’s physical health through the nutritional deficits they bring on and the additional stress they may place on vital organs, among other factors. And one area of the body that’s most routinely impacted by eating disorders is the heart.
When it comes to bulimia nervosa, in particular, the condition has been linked to a number of cardiovascular risk factors and other issues. 
Bulimia nervosa can also contribute to heart disease and premature death.
Generally, the tendency to purge—through methods like self-induced vomiting, laxative misuse, or excessive exercise—carries the biggest increased risk of developing cardiovascular issues. These types of behaviors have been associated with a wide range of heart complications, including: 
- Congestive heart failure
- Increased heart rate
- Heart muscle damage
Electrolyte imbalance is another issue often caused by binging and purging behaviors. This condition, in which the body fails to properly regulate fluids, can be potentially life-threatening, leading to heart failure and other complications. 
Common Types of Cardiovascular Disease Connected to Bulimia
While BN has been connected to a number of cardiovascular issues, there are some problems that are more commonly caused by the disorder.
Heart disease and premature death are, unfortunately, closely connected to BN, especially among women who struggle with the condition. One study on the subject found that women hospitalized for bulimia nervosa were more than four times more likely to develop cardiovascular disease compared to those not experiencing BN. 
10/1000 bulimia nervosa patients develop heart disease.
Various behaviors associated with bulimia nervosa, including self-induced vomiting, use of laxatives, excessive exercise, and restricted food intake, can increase a person’s risk of heart rhythm disorders, congestive heart failure, and sudden cardiac death.
In all, heart complications are fairly common among people with bulimia nervosa, with around 10 of every 1,000 patients developing heart disease each year. Of those 10, about three will eventually die due to related complications. 
Possible Treatments for Heart Problems Caused by Bulimia
In any case, actively treating bulimia nervosa will be a critical part of restoring someone’s health, including any heart problems that may have developed as a result of their eating disorder. Conversely, the longer someone goes untreated for BN, the more likely they are to develop a chronic nonreversible cardiovascular disease or a heart issue that may be fatal. 
At the minimum, a patient will likely need to enter an eating disorder treatment program to start getting the nutrients they need, normalize their weight, and reduce the strain their disordered eating behavior is having on their body. This is important not only to help improve cardiovascular health but also to improve overall physical and mental health, which is often devastated by BN.
In some cases, cardiovascular issues may be helped with medication, and, in extreme cases, surgery may be able to alleviate additional issues. But long-term adjustments to diet and exercise routines, as well as changes to other facets of someone’s lifestyle, such as the adoption of stress reduction techniques, can also generally prove helpful in keeping up or improving heart health.
But even if someone is successfully treated for any heart issues, the efficacy of the treatment will be tied to their eating disorder recovery. In nearly all cases where BN is involved, comprehensive care—ideally, a program that is equipped to address their physical needs as well as the mental health aspects of care—is the best solution for long-term recovery.
Finding Treatment for Bulimia
If you or a loved one are struggling with bulimia nervosa or another eating disorder, it’s crucial to seek out help. It’s never too late to start treatment, although it can be dangerous to wait until you experience serious complications.
Speaking with your physician, cardiologist, therapist, or another trusted medical professional can be a great place to start. These professionals may be able to help offer you an official diagnosis or otherwise help you plan your next best steps toward finding proper care.
If you’d rather not discuss this sensitive issue in person, a number of eating disorder hotlines can also help. These programs generally allow callers to remain anonymous while issuing additional information and resources on eating disorders and recovery options.
But regardless of where you turn for help, making the decision to seek it is the most important step. Eating disorders—and related heart health complications—may seem frightening and impossible to overcome, but with the right kind of care, it’s possible to start down the road to recovery.
- Rapaport L. (2019, October 22). Bulimia Tied to Higher Risk of Heart Disease and Premature Death. Reuters. Retrieved January 2023.
- 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: the Official Journal of the Gulf Heart Association; 16(3):88–92.
- Forney KJ, Buchman-Schmitt JM, Keel PK, & Frank GK. (2016). The medical complications associated with purging. The International Journal of Eating Disorders; 49(3):249–259.
- Olivero JJ. (2016). Cardiac Consequences Of Electrolyte Imbalance. Methodist DeBakey Cardiovascular Journal; 12(2):125–126.
- Tith RM, Paradis G, Potter BJ, Low N, Healy-Profitós J, He S, & Auger N. (2020). Association of Bulimia Nervosa With Long-term Risk of Cardiovascular Disease and Mortality Among Women. JAMA Psychiatry; 77(1):44–51.