Bulimia nervosa, or bulimia, is an eating disorder that leads to bingeing, purging, and other symptoms. The adverse physical side effects of bulimia may not be noticeable at first, but over time they can take their toll on the body.

Bulimia can also disrupt a person’s mental and emotional health. The side effects of this condition may be life-threatening, especially if the individual does not receive treatment.

In this article, learn about the signs of bulimia and its effects on the body.

Effects of bulimia

Bulimia can affect many areas of the body, including:

Face and mouth

Woman with acid reflux which may be an affect of bulimia on the body
Purging may cause acid reflux and stomach pain.

Purging by self-induced vomiting can cause a few noticeable effects in the face and mouth, including:

  • Tooth decay: Strong stomach acids may break down the gums and tooth enamel over time, which could lead to tooth sensitivity and cavities.
  • Puffy cheeks: Puffy cheeks may be a sign of swollen salivary glands, called sialadenosis.
  • Red eyes: Forceful vomiting can burst blood vessels in the eyes.
  • Raspy voice: The stomach acid in vomit may damage the vocal cords.
  • A cough: Ongoing acid irritation to the throat can cause coughing.

Bulimia can also cause sores, pain, and swelling in the mouth and throat.

Digestive tract

Frequent purging may also cause issues throughout the digestive system. Many people with bulimia experience digestive problems, including acid reflux and stomach pain.

The sphincter controlling the esophagus may become weaker, allowing acid to back up into the esophagus and causing gastrointestinal symptoms. Other possible digestive issues include diarrhea, bloating, and constipation.

Bloody vomit can occur if continued retching and vomiting result in a tear through the esophagus. This is known as a Mallory-Weiss tear, and it can cause life-threatening bleeding.

Frequent purging may also injure blood vessels near the anus, causing hemorrhoids.

People who use diuretics or laxatives to purge may have other digestive issues. Abusing these substances may lead to dependency, making it difficult or impossible for the person to have a normal bowel movement without using them.

Overusing diuretics that lower potassium and cause dehydration may also damage the kidneys, potentially leading to chronic kidney disease or kidney failure.

Mental and emotional health

depressed man
Bulimia can affect mental and emotional health.

Bulimia is a mental health condition. The feelings of guilt, shame, lack of control, and distorted body image that many people with bulimia experience seem to fuel the binge-purge cycle.

The burden of keeping the condition secret may also cause a person to feel additional stress and anxiety.

Other mental health concerns that commonly affect people with bulimia include:

  • major mood swings
  • depressive thoughts or actions
  • obsessive-compulsive behaviors
  • general anxiety
  • self-isolation
  • acts of self-harm
  • impulsive behaviors
  • low self-esteem

Cardiovascular and endocrine health

People with bulimia may not digest enough calories and nutrients to power their body. A lack of nutrients can cause bodily processes to slow down in an attempt to conserve energy. Forced vomiting and diarrhea can disrupt body chemistry, which can lead to the following issues:

Bulimia can also affect the pancreas. The pancreas functions as both an endocrine and exocrine gland to secrete insulin, hormones, and digestive enzymes. Bulimia may lead to inflammation of the pancreas, which is called pancreatitis.

Pancreatitis typically causes a range of signs and symptoms, including severe abdominal and back pain, nausea and vomiting, fever, and dehydration. The condition can be life-threatening and requires urgent medical care.

Over time, an electrolyte imbalance in people with bulimia and other eating disorders may increase their risk of severe cardiovascular complications. These complications can include abnormal heart rhythms and heart failure.

Dehydration and electrolyte imbalances

A loss of fluids, whether it occurs due to vomiting, overexercising, or using diuretics, can cause severe dehydration. Dehydration may lead to extreme fatigue and dangerous electrolyte imbalances. If people do not replace the lost electrolytes, they may be at risk of critical health issues, including seizures.

Dehydration and poor nutrition can also affect the hair, skin, and nails. The skin may become extremely dry, while the hair can turn very frizzy or fall out. The nails may become brittle and chip easily.

Reproductive health

pregnant woman sitting side profile holding baby bump
Pregnant women who binge and purge may put their babies at risk of complications.

A lack of calories and nutrients may cause hormonal imbalances in the body, which could lead to changes in the reproductive system.

Abnormally low estrogen and progesterone levels could cause people to stop menstruating. Some women’s ovaries may shut down and stop releasing eggs, making pregnancy impossible. A person with bulimia may also experience a loss of sex drive.

Pregnant women who binge and purge put themselves and their babies at risk of significant complications, including:

Lower levels of reproductive hormones may also lead to bone loss or increase the risk of osteoporosis and broken bones.

Understanding the binge-purge cycle

The two behaviors that define bulimia are bingeing and purging. Bingeing, or binge eating, is when a person eats much more food in one sitting than their body needs, often resulting in them feeling sick.

People who binge eat may feel ashamed and hide their eating habits from other people. Their family members, close friends, and partners may not even be aware of these habits. Other signs of binge eating can include:

  • hoarding or hiding stashes of food
  • having an irresistible urge to eat
  • feeling a loss of control upon starting to eat
  • eating to the point of physical pain
  • lying or making excuses about food to mask eating habits

Many people link their binge eating habits to feelings of shame. When the binge is over, the person may feel disgusted with themselves or be ashamed of their behavior. They may also be afraid that they will gain weight, which could make them feel the need to purge.

Purging is when a person tries to get rid of the extra calories they consumed while binging. Shame or a distorted body image can prompt the need to purge as well as the physical feelings of discomfort from having eaten so much.

People purge in different ways. Some people induce vomiting by stimulating their gag reflex. Others may abuse laxatives or diuretics. Some people may also starve themselves after a binge as an attempt to compensate for it.

Outlook

Bulimia is a serious eating disorder and mental health condition. The physical symptoms of bulimia can cause potentially life-threatening complications.

It is vital for anyone who has an unhealthy relationship with food to see a healthcare professional. A qualified doctor will need to address any symptoms or other issues that stem from bulimia. They may recommend treatments or refer a person to specialists to treat any other complications.

Although it will take time, treating bulimia is crucial to allow the body to heal. It is vital to understand that there is no shame in having an eating disorder and that help is available.