Bulimia Side Effects: Long-Term and Short-Term

Short-term side effects of bulimia are common, and those who struggle with the condition for extended periods may also face more serious long-term health issues.

Still, different types of therapies and other treatment approaches can help someone overcome bulimia nervosa, no matter how long they’ve been struggling.

Bulimia Side Effects and Purging

BN involves cycles of binge eating, where large quantities of food are eaten in relatively short periods of time, and purging, where that food is expelled or burned off.

The specific side effects of bulimia nervosa someone experiences depend on a number of factors, including age and overall health. But the type of purging method someone uses can also make a difference.

Many people associate BN with self-induced vomiting, and while that is a common method of purging, someone may also purge through:

• Misusing laxatives or diuretics
• Fasting
• Excessive exercise

These methods will have different impacts on physical health, both in the short- and long-term. Some patients may utilize several of these purging methods, which can put them at a higher risk of experiencing negative side effects of bulimia nervosa.

Short-Term Bulimia Side Effects

One of the first and most common symptoms of bulimia nervosa is gastrointestinal (GI) distress. These issues can occur regardless of the preferred purging method, as they’re frequently related to digestive disruptions caused by the binge/purge cycle.¹

Some common GI issues related to bulimia nervosa include:¹

• Nausea
• Bloating
• Feeling overly-full
• Irritable bowel syndrome (IBS)

Patients who utilize self-induced vomiting may experience additional complications, many of which are related to stomach acid repeatedly entering the esophagus and the physical strains involved in self-induced vomiting. Some of these bulimia side effects include:^1,2,3

• Gastroesophageal reflux disease (GERD)
• Acid reflux
• Heartburn
• Coughing
• Hoarse voice
• Sore throat
• Dry mouth
• Esophageal spasms
• Cuts or lesions along the hands or knuckles (known as Russell’s sign)
• Subconjunctival hemorrhages (bleeding in the eyes)

The misuse of laxatives can lead to electrolyte imbalance, which can cause other short-term health consequences, such as:^1,2

• Constipation
• Chronic, watery diarrhea
• Dehydration

In the short term, excessive exercise may also cause issues, especially a heightened risk of injury, swelling, or exhaustion. Someone utilizing this purging method may also see a change in body weight, though many people with BN maintain a “normal” body weight.⁴

Long-Term Side Effects of Bulimia

As someone continues to engage in cycles of binge eating and purging, they place more strain on their internal systems and may begin to experience more serious physical side effects. Some of these symptoms can be dangerous and require medical assistance to properly treat. 

Long-term issues connected to self-induced vomiting include:^1,2,3

• Dental complications, particularly tooth enamel erosion, from repeated exposure to stomach acid
• Achalasia, or the inability of the lower esophageal muscles to relax
• Swelling of parotid (salivary) glands, also called “bulimia cheeks“
• Rectal prolapse, caused by the strain of repeatedly vomiting

Overuse of laxatives can also bring on additional issues over time. Hypokalemia, or low potassium levels, is common and can cause many unpleasant and potentially serious side effects. Though rarer than the serious health problems caused by self-induced vomiting, a condition called “cathartic colon,” or difficulty passing stool, can also arise from long-term use of this purging method.¹

Those who utilize fasting may also experience complications, depending on how long and how stringently they reduce their food intake. While fasting for 24 hours or less does not generally have lasting consequences for health, fasting for longer periods can cause dangerous hormonal and metabolic changes and lead to malnutrition and many related issues.⁵

Most Serious Side Effects of Bulimia

The binge/purge cycle and the dangers of specific purging methods put an undue amount of stress on the body. Combined with several other individual factors, including someone’s medical history, physiology, age, and overall health, this can eventually lead to very serious, or even life-threatening, complications.

These side effects of bulimia nervosa are dangerous and require immediate medical attention:²

• Tears and bleeding in the esophagus (Mallory-Weiss syndrome)
• Abnormal cells in the esophageal lining (Barrett’s esophagus)
• Recurring, acute pancreatitis (swelling of the pancreas)
• Cardiac arrhythmia (abnormal heart rhythm)

In the most serious cases, BN can lead to congestive heart failure and sudden death. This is most often related to electrolyte imbalances, which can be caused by both regular vomiting and overuse of laxatives, particularly ipecac.²

Do Bulimia Side Effects Go Away After Treatment?

There is some good news. A majority of physical symptoms caused by BN abate as binging and purging behavior is reduced. Once someone stops engaging in this cycle, the body has the chance to heal itself, and often, a full recovery is possible.

One exception is swollen parotid glands. While this side effect of bulimia does go away on its own in a relatively short amount of time, it often occurs after someone stops self-induced vomiting behavior.³

Damage to teeth can be permanent, and serious enamel erosion and related issues will likely require medical intervention. Similarly, damage done to the heart in instances of cardiac arrest can be permanent.

Overall, however, as long as someone stops engaging in binge eating and purging and works on maintaining a balanced and healthy diet, they’ll be able to recover their physical health after struggling with bulimia nervosa.

Finding Treatment for Bulimia Nervosa

The good news is that BN generally responds well to treatment.

Cognitive behavioral therapy (CBT), a type of talk therapy, is very effective for many patients with bulimia nervosa, though a number of other therapies can also help. Patients also usually benefit from nutritional counseling and may do well with support groups, medication, or other interventions.

Still, to minimize the chance of lasting or even fatal damage, it’s important to seek treatment as soon as possible. A psychiatrist or mental health specialist can diagnose bulimia nervosa to help you get started on the recovery journey and find appropriate treatment programs. 

But regardless of how long you’ve struggled with the condition, it’s important to remember that appropriate care and support can make it possible to make a full recovery from bulimia nervosa at any time.