What Are the First Physical Side Effects of Bulimia?
The first physical effects a person with bulimia is likely to experience are the symptoms associated with purging, whether that purging is done through vomiting or misusing substances like laxatives or diuretics. 
Vomiting can cause inflammation in the throat, making it sore and potentially making swallowing painful. Laxatives and similar measures, such as enemas, may cause intestinal distress and otherwise irritate the bowels when abused. Diuretics may cause a person to become dehydrated, with some of the most immediate effects of dehydration being a headache and dryness of the mouth and lips.
Regardless of the purging method used, a person is likely going to experience gastrointestinal problems fairly early on, which will continue at various levels of severity as long as they continue their purging behavior. They also may experience significant hunger after purging, especially if they’re also practicing fasting and/or overexercising.
The More Serious Side Effects of Bulimia
As a person’s bulimia persists and they continue to engage in binge eating and purging, they may begin to experience more serious side effects. Some of these symptoms can be dangerous or may cause permanent or semipermanent damage to a person’s body.
A 2016 study showed various medical conditions affecting many of the body’s critical systems were associated with purging, including damage to the:
- Gastrointestinal system
- Musculoskeletal system
- Cardiovascular system
Vomiting was the purging method the study linked to the most complications, but all purging methods have the potential to damage a person’s body.  One issue is that vomit is highly acidic, and this acid can wear on the parts of the body it passes over during purging. Swelling of the salivary glands, wearing of the teeth, and acid reflux are all common.
Purging has the potential to cause severe dehydration and cause an electrolyte imbalance. In the wrong circumstances, a significant electrolyte imbalance can cause severe cardiovascular problems, such as stroke or heart attack.
Will These Effects Persist Through Treatment?
Many of the physical symptoms associated with bulimia will fade as a person enters treatment and begins to regain control over their eating and purging behaviors. Once a person is able to stop purging, the systems that their purging had taxed can begin to recover.
However, some damage may require the help of a doctor to treat. In certain cases, some level of damage may also be permanent, although it is important to note that recovery can help prevent these problems from worsening.
Swelling in the face, which is generally caused by swollen parotid glands (which are located near the ears), often requires medication to treat. In severe cases, it may require surgery in order to correct.
Dental damage caused by vomiting will also generally persist after a person recovers from bulimia. Significant teeth wear cannot always heal on its own, especially if decay occurs.
Organ damage, such as damage to the heart or liver due to the strain purging and malnourishment can have on those systems, can be semi-permanent. Generally, at least some of the damage dealt to these organs will heal if a person alters their habits and stops putting significant strain on them. However, organ damage is serious, and significant organ damage can sometimes have permanent or long-lasting effects.
Stroke or Heart Attack
If a person experiences a stroke or heart attack as a result of bulimia, this has the potential to cause permanent damage. A stroke can cause lasting brain damage, which may affect a person’s mobility, speech, and more.
Heart attacks can also potentially cause brain damage. Changing or outright stopping blood flow can prevent the brain from receiving oxygen, which is carried by the blood.
How Severe Can Bulimia Get if Untreated?
Left untreated, bulimia has the potential to cause organ failure. Heart and liver failure are two of the most common organs to fail as a result of bulimia. While rare, this can be fatal and will require medical treatment. Likewise, both stroke and heart attack can be life-threatening.
Complications due to purging are essentially inevitable, although the particular effects on the body will depend on the purging methods a person uses.
Bulimia is a long-lasting condition that doesn’t necessarily improve without treatment. Only 50% of people with bulimia fully recover after 10 years.  If a person’s symptoms continue for this length of period or longer, especially if they worsen, they will continue to experience a deterioration of their physical health.
The good news is that bulimia responds very well to treatment. With care focused on therapy, nutritional support, and complementary approaches, people can recover from bulimia.
Most of the physical side effects of bulimia can be managed, so people are able to enjoy happy, healthy lives in recovery. It’s important to get treatment as soon as possible to mitigate the long-term damage from the disorder.
- Diagnostic Criteria for Bulimia Nervosa (DSM-5). Medical Criteria. (2020, April 24). Retrieved June 7, 2022, from https://medicalcriteria.com/web/bulimia/.
- Forney KJ, Buchman-Schmitt JM, Keel PK, Frank GK. (2016). The medical complications associated with purging. International Journal of Eating Disorders, 49(3), 249-59.
- National Institute of Mental Health. (2021, December). Eating Disorders. Retrieved June 8, 2022.
- Hay PJ, Claudino AM. (2010). Bulimia nervosa. BMJ Clinical Evidence, 1009.