Bulimia nervosa is an eating disorder that has many adverse side effects. While it can affect both men and women, it’s more common in women. The National Association of Anorexia Nervosa and Associated Disorders reports that one out of every five women experiences this condition at some point in their life, leaving them recovering from bulimia nervosa, but it does affect men, as well.

Like most eating disorders, bulimia nervosa is about self-image and compulsive behavior. It is also the most fatal mental health condition in the U.S. This destructive pattern of eating that comes with bulimia nervosa takes a toll on both the mind and the body and can lead to life-threatening medical problems. What are the physical side effects of bulimia nervosa?

What Is Bulimia Nervosa?

Bulimia nervosa is an eating disorder characterized by binging food and then purging either by vomiting or the use of a laxative. The name translates into “nervous ravenous hunger.”

A person with this condition may also fast frequently and exercise more than most. They take whatever excessive measures they think are necessary to avoid gaining weight before and after they binge.

What Are the Causes of Bulimia Nervosa?

The causes of bulimia nervosa are not clear but there are probably many factors. It tends to run in families, for one thing, indicating that genetics may play a role. The National Association of Anorexia Nervosa and Associated Disorders suggest genetics makes up 50 to 80 percent of the risks that come with bulimia nervosa.

Bulimia nervosa is a mental health disorder and is sometimes linked to other mental health conditions like depression. There is a potential correlation between binge eating disorder and bulimia nervosa, too. Someone who severely restricts their food intake can trigger a binge-eating episode, which, in turn, triggers the purging. The combination creates a cycle that can damage the body.

That back and forth can make bulimia nervosa the difficult condition to spot, as well. Someone with bulimia nervosa may be average weight, for example, as opposed to under or over.

What Are the Physical Signs of Bulimia Nervosa?

Bulimia nervosa can lead to significant health problems. It’s when health consequences appear that many diagnoses are made because they are the first bulimia nervosa symptoms noticed. People exhibiting an eating disorder like bulimia nervosa put almost every system of the body in jeopardy. The health problems may be temporary ones that will fade once recovered or there may be permanent damage.

Bulimia Nervosa Effects on the Digestive System

The digestive or gastrointestinal system is one of the first impacted by bulimia nervosa. Damage here can lead to other medical problems, as well.

The gastrointestinal system includes the:

  • Mouth
  • Esophagus
  • Stomach
  • Intestines

It is a system that also may show the first signs of injury for those exhibiting the signs of bulimia nervosa. The symptoms are more benign at first, like a sore throat or stomach ache. Over time, the problems can increase.

Purging brings corrosive stomach acid up as well as food. The combination of physical pressure and stomach acid can lead to:

  • Tears in the esophagus
  • Ruptures in the esophagus
  • Irritation of the stomach lining
  • Damage to the intestines
  • Bacterial infections
  • Blood sugar fluctuations
  • Stomach rupture
  • Bezoar – Mass of undigestible matter blocking the intestine

It can also be the source of a potentially serious condition — gastroesophageal reflux disease (GERD). GERD affects approximately 20 percent of adults in western culture and, for some, it can is due to bulimia nervosa.

GERD occurs overtime as stomach acid moves up and down the esophagus. The acid irritates the lining of the tube and weakens the sphincter at the bottom of the esophagus. That sphincter is what keeps food and stomach acid in the stomach where they belong.

GERD can lead to complications like:

  • Esophageal stricture – Narrowing
  • Esophageal ulcers – Sores
  • Barrett’s esophagus — A condition associated with esophageal cancer

Overuse of laxatives and diuretics can cause damage to the small and large intestines, as well. It starts with constipation or diarrhea and maybe hemorrhoids. Eventually, laxative use can cause ulcers in the lining of the intestines. Constipation can lead to bowel obstruction and perforation.

Complications of laxative abuse include:

  • Lazy colon – the muscles fail to move waste out of the body
  • Colon infections
  • Irritable bowel syndrome
  • Colon cancer

In rare cases, laxative abuse can damage the liver, as well.

Bulimia Nervosa’s Effects on the Teeth and Gums

Stomach acid also affects teeth and gums. The acid breaks down the enamel on teeth and it irritates the gums. The damage can lead to:

  • Cavities
  • Brittle teeth prone to fracture
  • Mouth sores
  • Dry mouth
  • Gum erosion

Teeth may become loose or decayed enough that they must be replaced or removed completely.

Bulimia Nervosa’s Effects on the Circulatory System

The circulatory or cardiovascular system moves oxygen and nutrients throughout the body. It includes the:

  • Heart
  • Arteries
  • Capillaries
  • Veins
  • Coronary vessels
  • Lungs
  • Systemic circulation

One of the most serious complications of bulimia nervosa is its potential effect on this part of the body. Purging can mean dehydration that weakens the muscles including your heart. It puts electrolytes out of balance and that strains the heart as well.

Common circulatory problems from bulimia nervosa include:

  • Irregular heartbeat
  • Heart failure
  • Heart atrophy
  • Ruptured blood vessels
  • Low blood pressure
  • Anemia
  • Mitral valve prolapse
  • Low potassium
  • Torsade’s de Pointes

Poor nutrition can reduce the number of certain blood cells, too, lowering blood volume. Much of the damage to the heart is irreversible. Sudden death from cardiac arrest can occur due to the eating disorder’s effect on the heart rhythm and tissue.

Bulimia Nervosa’s Effects on the Reproductive System

Treatment-seeking individuals with bulimia nervosa can have significant nutritional deficiencies and hormone imbalances. The condition may stop a women’s menstrual cycle. The ovaries will no longer release eggs, too. The fatigue that comes with bulimia nervosa can also reduce sex drive.

If pregnancy occurs, the condition can lead to complications for both mother and baby.

Bulimia nervosa is associated with:

  • High blood pressure in mom
  • Gestational diabetes
  • Miscarriage
  • Premature birth
  • Breech birth
  • Low birth weight for babies
  • Birth defects
  • Stillborn babies
  • Problems breastfeeding
  • Postpartum depression

Laxative use can be harmful to a developing fetus and make the mother dehydrated putting the pregnancy at risk.

Bulimia Nervosa’s Effects on the Integumentary System

The integumentary system consists of anything that covers the body such as:

  • Skin
  • Hair
  • Nails

Most complications to the integumentary system are minor such as dry skin and nails but they can be long-term.

Dehydration that comes with frequent purging can make hair dry and brittle. It can become frizzy and difficult to manage.

Purging is often done by putting a finger down the throat. Russell’s sign is a common indicator of bulimia nervosa. It is a callous that develops on the knuckles of the hand due to repeated rubbing against the incisors while purging.

A more serious complication is infections. Poor nutrition and frequent dehydration can reduce the body’s ability to fight infection, so a break in the skin can become a bigger issue fast.

Bulimia Nervosa’s Effects on the Skeletal System

The human body is continually breaking down and rebuilding bone and that requires good nutrition. Most eating disorders including bulimia nervosa leave an individual poorly nourished.

In a pinch, the body will pull nutritional resources from the skeletal system to support more critical functions like the pumping and thinking brain. When that happens, bones lose density and can become weak and prone to fracture.

Bulimia Nervosa’s Effects on the Endocrine System

The endocrine system controls hormone production and includes glands such as the:

  • Thyroid
  • Adrenal
  • Hypothalamus
  • Ovaries
  • Parotid

These glands serve as the messenger system for the body, so when one is affected, all can potentially become unstable. They also communicate with other parts of the body such as the:

  • Heart
  • Kidneys
  • Liver
  • Gonads
  • Bones

Any of these are potentially affected when there is a problem in the endocrine system. Prolonged periods of poor nutrition can lead to a reduction in:

  • Sex hormones
  • Growth hormones
  • Thyroid hormones

When hormones are out of balance, there is a risk for:

  • Hypothyroidism
  • Hyperthyroidism
  • Insulin resistance
  • Type 2 diabetes
  • Low metabolic resting rate
  • A decrease in body temperature
  • Hypothermia
  • High cholesterol levels
  • Swelling of the parotid glands
  • Hypochloremia
  • Hyperphosphatemia
  • Metabolic alkalosis

When the messenger system shuts down, it impacts every organ and body function in some way.

Bulimia Nervosa’s Effects on the Neurological System

The brain consumes about one-fifth of the calories a person eats each day. When those calories are not there, it flips into survival mode. Restricted calories can lead to obsessing about food and poor concentration. Hunger can make it difficult to sleep, too.

Poor nutrition means the protective layer on the neurons breaks down leading to numbness in the extremities. Neurons also need electrolytes, specifically potassium, sodium, chloride, and calcium, to work properly. Purging can lead to dehydration that affects electrolyte balance. This can result in muscle cramps and, potentially, seizures.

Getting Treatment for Bulimia Nervosa

Recovering from bulimia nervosa will take a holistic approach to ensure each person gets the right help. Treatment will likely include dealing with the physical aspects of the condition, as well as the mental.

A medical problem such as diabetes is a co-occurring disorder. One of the initial steps of the treatment is an assessment to determine the needs of the person. This will most likely include a medical history and discussion of physical health.

Medical care to address these concerns should be integrated into the overall treatment plan.

The care program should include:

  • 24-hour medical oversight by a skilled nursing team
  • Complete medical history and physical exam
  • Medical monitoring and daily assessments
  • Medical appointments and check-ups as needed
  • Nutritional restoration for medical stabilization

They will also manage medications making sure each person gets prescription medication on schedule.

Education is an essential part of the process, as well. Treatment will provide tools to prevent further medical issues like nutrition education, mindful eating and cooking classes.

Education components could include working with a dietician to create an individual therapy plan.

  • Weekly cooking groups
  • Self-Portioning
  • Self-regulation
  • Mindful eating

Each year, 6.2 million people face the risk of death due to bulimia nervosa. It’s a condition that affects both teens and adults and has even been diagnosed in children.

Bulimia nervosa is a condition that has both mental and physical side effects. The more an individual knows about those side effects, the better. Information makes it possible to get to recognize the condition and get proper treatment.

Seeking treatment means some with bulimia nervosa can be recovered, reducing their risk of serious medical concerns like sudden cardiac death.

Treatment helps them set goals and develop a new relationship with their bodies through nutrition education and mindfulness. They develop an understanding of internal cues that improve how they feel and to shake free the negative habits to build positive reinforcement that improves lives.

Carrie Hunnicutt

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.

Oliver-Pyatt Centers is grounded in mindfulness and the belief that each person has the capacity for a mindful relationship with food and their body. Present in every aspect of our program, this philosophy encompasses nutrition and eating, as well as movement, with an emphasis on becoming free from negative habits, behaviors and rigidity. We work from a place of empathy and wisdom, using a medically grounded, psychologically gentle approach.

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Miami, Florida 33143

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