There are many complications that may affect patients that suffer from bulimia nervosa. The majority of the complications result from the methods used to purge food after a binge eating session, as frequent vomiting or use of laxatives can have significant adverse effects in several areas of the body.
The complications have been classified into several main types: electrolyte imbalance, dental issues, gastrointestinal damage, psychological issues and reproductive changes. Each of these is discussed in more detail below.
The concentrations of electrolytes in the bloodstream can become imbalanced as a result of the malnutrition and excessing vomiting or use of laxatives. In addition to symptoms such as fatigue and muscle weakness, this can also have an effect on the electrical activity of the heart. In particular, the heartbeat can become irregular and lead to arrhythmias, which has the potential to be fatal.
The electrolyte imbalance in the blood can also have an effect on other organs and systems within the body. For example, it may cause damage to the kidneys or cause muscle spasms and convulsions.
Dental complications are particularly common for individuals that purge following a binge-eating session by vomiting, as the acidity from the stomach can cause significant damage to the mouth and teeth. This usually begins as discoloration of the teeth but can progress to tooth decay and inflammation or disease of the gums. Bad breath and a constant sore throat are also common symptoms associated with vomiting.
To prevent tooth decay and cavities, fluoride applications, mineral supplements and rinsing mouth with water after purging can be useful. The teeth should not be brushed, as this can rub off the enamel and worsen decay. In most cases, dentists prefer to wait until the individual has recovered from bulimia to perform corrective procedures, to prevent it from recurring.
For patients that use laxatives to purge after a binge eating session, there is a risk of intestinal damage and the potential for permanent changes to bowel movements. The muscles in the gastrointestinal tract can become damaged, causing symptoms of constipation that may be permanent.
For patients that vomit to rid the food after a binge eating session, the stomach and esophageal lining can be damaged. The stomach acid and bile can cause irritation and inflammation of the esophagus, to cause tearing, scarring and narrowing of the airways. Tears can lead to rupture and bleeding, which requires immediate medical attention. There is also an increased of Barret’s esophagus.
Patients affected by bulimia nervosa are more likely to suffer from depression or anxiety. This can impact the quality of life of the individual significantly and contribute to social isolation, in addition to increasing the probability of suicidal thoughts and attempts.
It is important that patients suffering from an eating disorder such as bulimia nervosa have access to a strong support network. This helps them to fell connecting and understood by other individuals, and can help to promote positive psychological outcomes.
Women who are affected by bulimia nervosa may find that their menstrual cycle becomes unpredictable and may cease completely, known as amenorrhea. Additionally, there is an increased risk that affected individuals will have difficulty conceiving in the future and it may cause infertility in some cases.