What Are the Psychological and Physical Effects of Bulimia Nervosa?

Bulimia nervosa is a well-known type of eating disorder that centers around repeating episodes of binge eating, followed by compensatory purging behaviors. The purging behaviors are most often some form of self-induced vomiting, but they are often combined with excessive exercise, fasting, and laxative abuse. Both binge eating and the following behaviors can result in several different physical effects on the body, some very serious.

The physical side effects of bulimia nervosa can become serious if the behavioral symptoms go untreated, making early intervention important for long-term physical and mental recovery. As parents and family members help their loved ones look for the best nearby bulimia nervosa recovery programs, it is important to keep these many long-term side effects in mind.  Ideally, they can find a program that emphasizes both psychiatric and medical care. A treatment program that ignores either aspect, i.e. only physical treatment or only counseling, won’t be nearly as effective as an integrated one.

Physical Effects of Bulimia Nervosa

The Short-Term Effects of Bulimia Nervosa

While most people are familiar with some of the physical signs of bulimia nervosa that are related to frequent vomiting – like bad breath, frequent sore throats, and facial swelling – many long-term health effects are not quite as immediate and might necessitate a doctor’s diagnosis to identify. Tooth decay is especially common in longstanding cases of bulimia nervosa, due to the repeated cycle of self-induced vomiting to get rid of calories taken in during a meal or binge eating episode. This is because the content of the stomach is usually highly acidic and over time, these acids can break down the tooth enamel.

Other common short-term health effects of bulimia nervosa, which are related to not only vomiting but also over-exercising and laxative abuse include:

  • Severe Dehydration
  • Fluctuating weight
  • Heart Arrhythmia
  • Constipation and Other Gastrointestinal Issues
  • Difficulty Sleeping
  • Dry Skin
  • Increased Risk of Stroke
  • Dental decay
  • Calloused knuckles

These kinds of symptoms are good early indicators that bulimia nervosa is beginning to develop, and it’s important to catch it early on. Early intervention is key for the best outcomes for bulimia nervosa treatment.

The Long-Term Effects of Bulimia Nervosa

Bulimia nervosa recovery is not only important for one’s mental health but their physical health as well. The long-term effects of bulimia nervosa are very serious and even more dangerous than the short-term ones, and several can lead to chronic health issues and even premature death. If left untreated, the repeated stresses on the body and mind of ballooning weight and nutritional purging can result in various health concerns. These include:

  • Bone Weakness – If the body does not get enough nutrients, the bones are unable to fully develop the right amount of mineral density. As a result, people with bulimia nervosa are at a much higher risk of osteoporosis, a degenerative bone disease usually found only in senior women.
  • Electrolyte Imbalances – Frequent vomiting and the resultant loss of fluids can result in severe electrolyte imbalances. Untreated electrolyte imbalances can have a hugely negative effect on heart function and in many cases, leads to a higher risk of a heart attack. Heart failure is one of the most common causes of death related to bulimia nervosa, making troubles with electrolyte balance potentially deadly.
  • Disruption or Loss of Menstrual Cycle – Women with bulimia nervosa are at great risk of experiencing infrequent menstrual periods with a condition known as oligomenorrhea. This condition is caused by poor nutrition and can affect fertility. In fact, even those who are in bulimia nervosa recovery may find that it takes some time for their periods to return to normal and they can conceive. Reproductive difficulties can also become permanent in some cases.
  • Brain Disfunction and Damage – In the long term, bulimia nervosa can affect brain function in several ways. First, malnutrition caused by repeated purging can cause diminishing cognitive function. This affects memory, higher-level, and abstract thinking, decision making, and emotional response negatively. Seizures or strokes can also occur. In the second place, the brain can also be caught in a dopamine-release cycle that forces the brain to crave bulimic actions, similar to drug addiction.

Psychological Effects of Bulimia Nervosa

Short Term Psychological Effects of Bulimia Nervosa

Like most eating disorders, the onset of bulimia nervosa is not a sudden one, but rather develops slowly over time. Disordered behaviors such as binging and purging are usually the last psychological symptoms to appear. Beforehand, most people with bulimia nervosa display symptoms of low self-esteem and body image distortions before they being to use purging behaviors. Some of the other short-term psychological effects of bulimia nervosa include:

  • Body image distortions
  • Feelings of worthlessness
  • Low self-esteem
  • Constant comparisons to other people
  • Fad dieting or other extreme weight-loss attempts
  • Discomfort or unease at mealtimes
  • Discomfort eating around other people
  • Making attempts at hiding their body’s shape
  • Increased shyness and self-isolation
  • Decrease in school or work performance

The distinctive behaviors of bulimia nervosa must be observable for six months before a diagnosis can be officially made. However, people with this disorder are known to switch between other disordered eating patterns, making a diagnosis more difficult. For example, a person may binge eat and then purge for several months, but then stop binge eating in favor of a food restriction pattern such as is found in anorexia nervosa. Because of this, a short-term diagnosis of bulimia nervosa may be impossible. Treatment for these cases must be carefully planned to address every kind of disordered behavior presented.

Long-Term Psychological Effects of Bulimia Nervosa

There is no “quick cure” for any mental health disorder, bulimia nervosa included. Even with professional treatment, the psychological effects of the disorder can last for years and be prone to relapses. Complicating recovery even further, eating disorders rarely occur in a vacuum. Dual diagnoses – that is, one or more co-occurring disorders happening at the same time as bulimia nervosa – are commonplace. Whether these trigger an eating disorder or are triggered by them is a bit of a chicken-or-the-egg proposition; what’s known, however, is that they do affect one another. Some of the long-term psychological effects of bulimia nervosa include:

Depression –The feelings of losing control over one’s actionscan contribute to a newfound or increased spate of depression. This most common of mental health disorders have numerous negative effects on a person’s wellbeing – depression can cause insomnia or chronic fatigue, feelings of worthlessness or hopelessness, lack of motivation, and most troubling for people with an eating disorder, weight gain or weight loss. Depression is also associated with substance and alcohol abuse.

Anxiety –Anxiety is unreasonable worry ornervousness about the future and extensive obsession with events of the past. It can come in many forms – for example, a person with social anxiety might feel extreme discomfort about being judged in public situations, so much so that interaction becomes an unbearable obstacle. Or a person might suffer from PTSD, where the trauma from a past event becomes a current-day panic attack. The distinctive binging and purging behaviors of bulimia nervosa provide temporary relief from these feelings and gives the individual the sense of taking control over some aspect of their lives. However, this relief comes at a cost – i.e. the many negative effects of bulimia nervosa.

Obsessive-Compulsive Disorder –We mentioned earlier that the disordered eating behaviors associated with bulimia nervosa can become akin to an addiction. While this is broadly true, it may be more accurate to say they become a compulsion. The similarities between OCD and bulimia nervosa have been noted by many eating disorder treatment centers and psychiatric experts. In both cases, the individual with the disorder feels an uncontrollable compulsion to behave a certain way or take a certain action – frequently and repeatedly.

Suicide – The rate of suicide among people with bulimia nervosa (and other eating disorders) is more than twice as high as the same rate among the general population. Depression and major anxiety disorders often come hand-in-hand with bulimia nervosa, so people getting intensive bulimia nervosa treatment may need a suicide watch. Residential treatment programs often make this a priority for new clients.

Seeking Treatment for Bulimia Nervosa

While there are many potentially life-threatening health effects associated with bulimia nervosa, with proper treatment and continued care, it is possible to enjoy a successful recovery. Depending on the severity of the condition, it may be necessary for individuals to seek treatment in a facility that offers both medical and psychiatric care – so seek out a facility that takes this into consideration.

Some forms of treatment used for eating disorders include:

Cognitive Behavioral Therapy (CBT)

CBT aims to identify which thoughts and feelings are causing disordered behaviors, objectively understand them, and eventually replace them with more rational ones that do not cause negative behaviors. As the client progresses through CBT sessions in an eating disorder treatment context, they will begin to replace the disordered coping mechanisms (such as binging and purging in the case of bulimia nervosa) with healthier ones, such as journaling or practicing a hobby. CBT is a gradual process, in which the client and therapist incrementally make progress in repairing the negative thoughts and feelings involved in their disorder.

Dialectical Behavioral Therapy (DBT)

An offshoot of CBT, Dialectical Behavioral Therapy was originally designed to treat Borderline Personality Disorder, a mental health condition in which a person has difficulty regulating emotion and building relationships. DBT is focused on mindfulness, or the ability to observe feelings and thoughts without acting on them or judging them. It’s useful for eating disorders as well as BPD because it directly impacts a person’s ability to regulate their actions irrespective of what negative or distorted emotions they are feeling.

Cognitive Processing Therapy

CPT is another evolution of CBT that was designed specifically to address PTSD or other forms of trauma and the coping behaviors that can arise from them. CPT is clearly outlined in 12 sessions between a client and a single therapist. Its main focus is addressing trauma, the event that caused it, and its emotional consequences. Like CBT and DBT, cognitive processing therapy begins with objectively identifying emotional disturbances without acting on them or judging them.

With 20 years of behavioral health business development experience, Carrie combines world-class marketing, media, public relations, outreach and business development with a deep understanding of client care and treatment. Her contributions to the world of behavioral health business development – and particularly eating disorder treatment – go beyond simple marketing; she has actively developed leaders for her organizations and for the industry at large.