What are the physiological effects of bulimia?

Índice Show

Physical Effects of Binge Eating
Effects on the stomach
Effects on body weight
Physical Effects of Self-induced Vomiting
Physical Effects of Laxative and Diuretic Use
Psychological Effects
Social Effects

Like all eating disorders, bulimia is a serious illness. It can permanently damage your body and can even be deadly.

People with bulimia will often eat large amounts of food, or binge, and then try to get rid of the calories in what is called a purge. This often involves vomiting, excessive exercising, or abuse of laxatives or diuretics. This cycle of behaviors can cause problems to all parts of your body.

Bulimia also affects your brain and is often linked to mental health problems like anxiety and depression.

But you can get help. There are many treatment options to stop the cycle of binging and purging. Just be sure to do them with the help of a doctor so that your recovery is safe.

The cycle of bingeing and purging takes a toll on your body. It can cause damage to everything from your heart and digestive system to your teeth and gums. It can create other problems as well, including:

Dehydration. Your body loses fluids when you throw up or overuse diuretics.
Electrolyte imbalances. When you get very dehydrated, you lose electrolytes. These are chemicals such as sodium and potassium. They help your body keep the right amount of fluid in your blood vessels and organs. An electrolyte imbalance could lead to heart problems and even death.
Heart problems. These can include a rapid, fluttering, or pounding heart (called palpitations) and an abnormal heart rhythm, which is called an arrhythmia.
Low blood pressure. Your blood pressure might drop so low that you're at risk of fainting.
Trouble regulating body temperature. When you don’t eat enough to fuel your body, your body temperature may drop. You might feel cold all the time.
Damage to your esophagus. Forceful vomiting can cause tears in the lining of your esophagus, the tube that connects your throat to your stomach. If it tears, it can cause severe and life-threatening bleeding. This is known as Mallory-Weiss syndrome. Bright red blood in your vomit is a symptom of this syndrome.
Burst esophagus. Repeated forceful vomiting can also cause your esophagus to burst. This is called Boerhaave syndrome. It's an emergency and needs immediate surgery.
Acid reflux. When the lower part of your esophagus gets damaged, stomach acid can come back up through it. That causes indigestion and heartburn.
Other digestive problems. Bulimia can permanently damage your stomach and intestines, causing other problems like constipation, diarrhea, and irritable bowel syndrome.
Hormonal problems. Reproductive issues, including irregular periods, missed periods, and fertility problems are common side effects when you have bulimia.
Diabetes connection. If you have type 1 diabetes and an eating disorder, you may also have a condition that has been called diabulimia. The term describes people with diabetes who need insulin but deliberately take less than they're supposed to in an effort to lose weight. This can lead to serious health problems like stroke, coma, and death.
Tooth decay. The stomach acid in vomit can damage tooth enamel, making your teeth sensitive to hot and cold.
Mouth problems. Stomach acid can also discolor your teeth and cause gum disease. Throwing up from purging creates painful sores in the corners of your mouth and soreness in the throat. And bulimia can lead to enlarged salivary glands in your mouth.
Ipecac-induced myopathy, or muscle weakness. While some people use their fingers to make themselves throw up, others may use ipecac syrup, which was once used to make people throw up when they had been poisoned. Drinking too much ipecac over time can cause permanent heart damage and even death.
"Bulimia face."Swollen salivary glands from too much throwing up can make your face and neck look puffy.
Hoarse voice. When you vomit often, stomach acid may irritate your vocal cords and affect your voice.
Russell’s sign. Regularly using your fingers to make yourself throw up can make the back of your finger joints discolored or callused. This skin condition is called Russell’s sign.
Hair, skin, and nail problems. When you don't get enough nutrients, your hair, nails, and skin sometimes get dry. Your hair and nails may break off easily, and your hair can thin out. Vomiting might cause small broken veins on your face, red areas around your mouth, or a purple rash.
Pancreatitis. This is an inflammation of the pancreas that can cause pain, nausea, and vomiting. Either malnutrition or purging can cause it.
Difficulties during pregnancy. Bulimia raises your risk for having a miscarriage or a C-section. It also makes it more likely that your baby will be born prematurely, be small, or have a birth defect. And it increases the odds that you'll have depression after the baby is born.

Aside from the physical damage bulimia does to your body, it's also linked to mental health problems. Some of the issues that you could deal with include:

Anxiety
Depression
Low self-esteem
Irritability
Moodiness
Self-harm (such as cutting)
Obsessive-compulsive behaviors
Guilt, shame, or embarrassment
Drug or alcohol abuse
Suicidal thoughts or actions

If you’re having any thoughts of harming yourself or committing suicide, call your doctor or 911 immediately. You can also call the free National Suicide Prevention Lifeline at 800-273-8255. They are there to help you.

Recovery from bulimia can take a long time. But don’t let that stop you from getting help. If you're willing to seek treatment, there are many options that you, your family, and your doctor can discuss to create a plan that will work for you. Set goals, stick to your plan, and you can be on your way to overcoming this eating disorder.

Bulimia nervosa is a type of eating disorder that is becoming increasingly prevalent all over the world. According to the DSM-5 criteria, to receive a diagnosis of bulimia nervosa the person must display:

Recurrent episodes of binge eating, which are characterised by both of the following:
1. Eating, in a discrete period of time (2-hour period), an amount of food that is larger than most people would eat during a similar period of time and under similar circumstances.
2. A sense of loss of control over eating during this episode, i.e., a feeling that one cannot stop eating or control how much or what one is eating.
Recurrent inappropriate compensatory behaviours in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, fasting, or compulsive exercise.
These behaviours both occur, on average, at least once a week for three months.
Regarding weight and shape as central to one’s self-worth (i.e., “overvaluation of shape/weight”).
The disturbance does not occur exclusively during episodes of anorexia nervosa.

Bulimia nervosa is connected to a whole host of negative physical, psychological, and social outcomes. In this article, I will provide a comprehensive review of the different effect’s bulimia nervosa has on a person’s functioning.

Physical Effects of Binge Eating

Effects on the stomach

People who binge eat consume a lot of food in a short period of time.

Therefore, in some cases the effects of binge eating on the stomach can be intense and painful and can leave a person feeling breathless.

In extreme and rare cases, the stomach may actually stretch so much that it tears.

Seek immediate medical help if this occurs.

Effects on body weight

Prolonged binge eating is associated with weight gain.

Although people with bulimia nervosa vomit deliberately to compensate for the excess calories consumed, this method of weight control only expels around 50% of the calories consumed.

The repeated cycle of restriction and binge eating means that body weight will constantly fluctuate in people with the bulimia nervosa.

Physical Effects of Self-induced Vomiting

Dental consequences: Repeated vomiting erodes the dental enamel on the inner surface of the front teeth. Other abnormalities in the oral cavity include reduced salivary flow rate, tooth hypersensitivity, dental caries, and xerostomia (dry mouth). Gum disease is also common after prolonged self-induced vomiting.
Throat damage: Self-induced vomiting stimulates the gag reflex with a significant degree of force. Injury and infection to the back of the throat is common. A chronic sore throat it also typical.
Oesophagus damage: Prolonged vomiting can tear the wall of the oesophagus, causing significant bleeding. This is a medical emergency and help should be sought.
Dehydration and electrolyte imbalance: Repeated vomiting flushes out much of the bodily fluids and can cause severe dehydration. It can also cause severe depletion of potassium and sodium levels. Symptoms of dehydration and electrolyte imbalance include:
- Irregular heartbeat
- Extreme thirst
- Dizziness
- Swollen arms and legs
- Lethargy
- Death

Physical Effects of Laxative and Diuretic Use

Both of these compensatory behaviours can also cause dehydration and electrolyte imbalance.

In extreme cases, prolonged and extreme laxative use can permanently damage the intestines.

Diuretic use can also cause muscle cramps, headaches, and frequent urination.

Psychological Effects

The psychological consequences of bulimia nervosa are profound, debilitating, and can significant impact the functioning of those afflicted by the disorder. Common psychological effects of bulimia nervosa include:

Depression: ~60% of with bulimia nervosa also have clinically significant depression. In fact, early research has shown that the severity of depressive symptoms in those with bulimia nervosa are comparable to those with a depressive disorder!. The relationship between bulimia nervosa and depression is bidirectional – that is, both tend to cause or influence each other.
Anxiety: ~65% of people with bulimia nervosa also have a clinically significant anxiety disorder. The most common comorbid anxiety disorders are obsessive-compulsive disorder and social phobia. Comorbid anxiety symptoms usually intensify in situations that involve eating (e.g., going to a wedding or a party) or some degree of body exposure (e.g., going to the beach). This can explain why some people with bulimia nervosa isolate themselves.
Alcohol and substance abuse: abusing alcohol or drugs are common behaviours in nearly 70% of people with bulimia nervosa. People with bulimia nervosa typically have poor emotion regulation strategies, so they often resort to drugs and alcohol (in addition to eating) as a means to cope with negative situations. The devastating and seemingly chronic symptoms of bulimia nervosa can instill a sense of hopelessness, forcing people to resort to alcohol or drugs.
Low self-esteem: a pervasive negative view of the self is both a cause and consequence of bulimia nervosa. It causes the disorder because it encourages people to achieve in the valued domain of weight and shape (the core psychopathology of bulimia nervosa). And it is a consequence of the disorder because the repeated dietary failures that cause binge eating forces people to be extremely self-critical. Interestingly, self-esteem deficits in bulimia nervosa may even be lower than the self-esteem deficits observed in people with a depressive or anxiety disorder .

The social effects of bulimia nervosa are also quite significant. In fact, many psychological treatments for bulimia nervosa aim to overturn these negative social effects, with the belief that fostering healthier social skills will indirectly address the core symptoms of bulimia nervosa.

Some important social effects include:

Relationship breakdowns: It is extremely common for people with bulimia nervosa to destroy the relationships they have with significant others. The reasons for this are complex. However, it may have to do with the fact that these people (a) tend to isolate themselves in order to achieve in their valued domain of weight and shape, and (b) are secretive and will go to great lengths to hide their behaviours.
Comparison making: People with bulimia nervosa will regularly compare themselves to others. The comparisons are unfair; people with bulimia nervosa will heavily scrutinize themselves to the nth degree while simultaneously making a very superficial assessment of the other person with which they are comparing to . Frequent comparison making can cause people to feel down, lonely, isolated, and worthless.
Intimacy problems: Intimacy problems are a core side effect of bulimia nervosa. Many romantic partners and spouses report that they feel second place to the eating disorder and emotionally and physically distant from their partner. Low body weight, physical complications, and hormonal imbalances can decrease a woman’s sexual drive, which can explain why women with bulimia nervosa avoid sexual intercourse. Other characteristics of the disorder that have a direct effect on romantic intimacy include low self-esteem, body image distortion and shame.

Conclusion

As highlighted in this article, the consequences – both physical, psychological, and social – of bulimia nervosa are profound and take an enormous toll on the functioning of those affected by the disorder.

Many of these consequences can be reversed if the disorder is adequately treated. There are a range of evidence-based treatments for bulimia nervosa, including cognitive-behaviour therapy, interpersonal psychotherapy, and family therapy.

It is recommended that you seek out resources to get in control of this disorder. Various self-help books can be purchased. Or seek out professional counselling from a trained mental health professional.

Break Binge Eating’s information and advice is developed and managed within a rigorous evidence-based framework. This content was written and reviewed by Dr Jake Linardon, PhD, a Research Fellow and Lecturer of Psychology at Deakin University, Melbourne Australia.