Bulimia Nervosa Complications

There are many complications that may affect patients who suffer from bulimia nervosa. The majority of complications are due to the methods that are 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 of bulimia have been classified into several main types including electrolyte imbalance, dental issues, gastrointestinal damage, psychological issues, and reproductive changes.

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Electrolyte imbalance

The concentrations of electrolytes in the bloodstream can become imbalanced as a result of malnutrition, excessive vomiting, and/or the use of laxatives. In addition to symptoms such as fatigue and muscle weakness, an electrolyte imbalance 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, this complication of bulimia may cause damage to the kidneys, muscle spasms, and/or convulsions.

Dental issues

Dental complications are particularly common for individuals who 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 the 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 and prevent these dental issues from recurring.

Gastrointestinal damage

For patients who 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 who vomit to rid of 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, which can lead to tearing, scarring, and narrowing of the airways. Tears can lead to a rupture and bleeding of the affected areas, which requires immediate medical attention. There is also an increased risk of Barret’s esophagus in bulimia patients.

Psychological issues

Patients affected by bulimia nervosa are more likely to suffer from depression or anxiety. This can significantly impact the quality of life of the individual 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 feel connected and understood by other individuals, and can help to promote positive psychological outcomes.

Reproductive changes

Women who are affected by bulimia nervosa may find that their menstrual cycle becomes unpredictable and may cease completely, which is a condition known as amenorrhea. Additionally, there is an increased risk that affected individuals will have difficulty conceiving in the future, as bulimia may cause infertility in some cases.


Further Reading

Last Updated: Feb 21, 2023

Yolanda Smith

Written by

Yolanda Smith

Yolanda graduated with a Bachelor of Pharmacy at the University of South Australia and has experience working in both Australia and Italy. She is passionate about how medicine, diet and lifestyle affect our health and enjoys helping people understand this. In her spare time she loves to explore the world and learn about new cultures and languages.


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