The Effects and Health Risks of Bulimia

Bulimia is one of the top 5 eating disorders, and while some of the effects of this disease are apparent, there are still many that lay dormant under the surface.

When you think of bulimia, you conjure images of bingeing and purging, but these are just out-lying symptoms. In addition, many people living with bulimia are of average weight, so it is sometimes difficult to see the signs of damage.

Bulimia causes damage to critical systems that keep our bodies alive, and some are irreversible.

This guide is by no means a comprehensive listing of all bulimia health risks, but we hope it will serve as a cautionary tale for those affected, or for those who know someone affected by this disease.

Let’s look a little deeper at the effects of bulimia on many of the body’s critical systems.

Bulimia’s Effects on the Central Nervous System

Bulimia is not just an eating disorder, it is also a mental health disorder. Many sufferers experience compulsive behaviors, irritability, depression and moodiness. Some of these are from the disease itself, while others are due to vitamin deficiencies resulting from poor nutrition.

When we dig a little deeper, there is considerable evidence showing bulimia is tied to an altered brain serotonin (5-HT) function, ^[1] which is what regulates your mood, appetite and impulse control. When this function is altered in any way, it causes a change to the “regulators:” things that control our mood, things that tell us whether we still want to eat, and things that tell us whether or not we should give in to our impulses. Unfortunately, this is one of the characteristics that makes this disease so difficult to address.

Among some of the more outward symptoms of bulimia is compulsive behavior. Whether it’s the constant monitoring of calories, or the obsession with appearance, many bulimia sufferers experience some damaging form of compulsive behavior. Some become so focused on food or appearance as something they must control, that they find themselves excluding activities not related to these things. Compounding this is the fact that constant overanalyzing of food and appearance contributes to anxiety and depression, or worsens those conditions if they already exist.

Anxiety, worsened by people “prying,” is one of the main reasons this condition could remain undetected for a long time. When those who suffer from bulimia are trying to disguise the symptoms, they often lie, binge in secret, or hide evidence of laxatives and stores of food. This activity all takes a mental toll on the brain. It also leads to a mental state of distrust and eventual alienation from things and people that used to bring happiness.

But again, under the surface, there is more going on. Internally, bulimia is known to cause endocrine disturbances, which makes the disorder more difficult to reverse.

“People with eating disorders often enter a downward spiraling circle with malnutrition sustaining and perpetuating the desire for more weight loss and dieting.”

Because of the impact on mental health, this is a self-perpetuating disease – a dangerous cycle that can feel as though it is out of the sufferer’s control.

A simple change in diet will often not be enough. Studies have shown that mental therapy should be included as a treatment, in conjunction with food therapy, and that it should be continued for months after the nutritional side has been addressed.

Bulimia’s effect on the central nervous system is just the beginning. Some of the more apparent signs happen within the digestive system.

Bulimia’s Effects on The Digestive System

The primary function of the digestive system is to break down the food you eat into absorbable nutrients and guide any waste out of the body. When a damaging cycle of bingeing and purging happens, this disrupts the digestive system’s normal function and causes a wide range of “uncomfortable” side effects.

Contrary to what you may believe about popular diets, your body needs various nutrients, including fats, carbohydrates, proteins, vitamins, water, and minerals. Unfortunately, those who have bulimia are often deficient in one or more of these categories. This deficiency takes its toll on many vital parts involved with digestion, including:

Mouth: When you purge or force yourself to vomit, the stomach acid can damage your tooth enamel. Over time, this leads to tooth sensitivity and decay. Stomach acid can also discolor your teeth or cause painful gum disease.

In addition, constant purging can lead to mouth sores, chronic sore throat, or even swollen salivary glands. All in all, this is just the beginning of the effects of bulimia on the digestive system.

Esophagus: Moving down the digestive track is the esophagus – the tube-like structure connecting the throat to the stomach. Continual force vomiting can lead to minor tears in the lining of the esophagus and could cause Mallory-Weiss syndrome. This is when tears become so apparent, they are life-threatening and marked by bright red blood showing in the vomit.

Another related syndrome, Boerhaave syndrome, happens when repeated, forced vomiting causes the esophagus to burst. In this case, immediate surgery is necessary.

Sometimes, gastric reflux, GERD (Gastro-Esophageal Reflux Disorder) is caused by repeated, forced vomiting that weakens the “doorway” between stomach and esophagus. Once this occurs, partially digested food and stomach acid can migrate between the two areas, resulting in a burning sensation and eventual erosion of the esophagus.

This issue can also lead to the cancer pre-cursor called Barrett’s esophagus, caused by the acid traveling between the stomach and esophagus that leads to erosion or lesions on the esophagus. These lesions are precancerous.

Acid reflux is another uncomfortable consequence of bulimia in the lower esophagus. When the esophagus is damaged, sometimes stomach acid can find its way back up the tube, causing indigestion and heartburn.

Stomach/Intestines: At the lower end of the spectrum, bulimia can cause permanent damage to the stomach and intestines, which can show outwardly as irritable bowel syndrome (IBS), constipation and even diarrhea.

In the case of the colon, the overstimulation of the bowels from laxative abuse can lead the colon to shut down. The colon can shut down because the laxatives do their job by stimulating the colon through irritation leading to watery stools or, on the other extreme, by increasing the mass of the stool, which can overstretch the bowel.

Over time, continued abuse of laxatives and engaging in bingeing and purging activities can also lead to rectal prolapse. Rectal prolapse happens when the rectum bulges through the anus from chronic straining.

When it comes to the bingeing, there is a danger of developing acute gastric dilatation. This symptom happens when there is a delay in emptying the bowels, and the stomach fills up with food. When the stomach can’t drain, this obstructs blood flow and can cause “dead gut” or even gastric rupture. Dead gut is a condition where blood flow is interrupted and a part of the intestine “dies.”

The good news? Many of these side-effects of bulimia can be reversed or have progression slowed with treatment.

Bulimia’s Effects on The Circulatory System

The circulatory system can be an overlooked system unless there is a problem. Bulimia’s effects on the circulatory system are understandably made even more dangerous by their covert nature. Whether apparent or not, however, the damage is occurring.

Because the circulatory system is part cardiovascular (heart related), part pulmonary (lung-related), and part systemic (artery/vessel related), it provides the main pathway for the body to receive its nutrients. As noted in the other effects of bulimia, one of the side effects is poor nutrition. When there is a lack of nutrition to deliver to the body’s cells, they begin to break down on a cellular level.

When you think of dehydration, you don’t think of death per se, but constant dehydration from bulimia is a different story. Long-term misuse of laxatives can cause an electrolyte imbalance, leading to an increased risk for heart arrhythmias, or irregular heartbeats. ^[2]

Electrolyte imbalances are linked to dehydration through purging, which causes the body’s water volume to drop significantly and quickly. Too much water loss and there is a risk of hypovolemic shock (low blood volume), kidney failure, seizures, or even heart failure.

In the heart, bulimia has been known to cause damage to cardiac myocytes, a muscle structure near the heart that helps the heart contract and retract. This damage leads to severe conditions such as congestive heart failure, ventricular arrhythmia, or even sudden cardiac death. ^[3]

If heart problems and cardiovascular issues weren’t enough, constant sufferers of bulimia have experienced many of the damaging effects bulimia has on the reproductive system.

Bulimia’s Effects on The Reproductive System

For women suffering from bulimia, most of the effects stem from the nutritional deficiencies they experience. Deficiencies in vitamins can lead to irritability and cause hormonal imbalances, which can negatively affect sex drive.

Even with that, the most commonly seen, and early indicator, is a lack of menstrual cycle. Many female sufferers experience a change in their expected period or stop altogether.

The stopping of the menstrual cycle doesn’t just mean no more period, it means the entire cycle stops – including the ovaries that stop releasing eggs.

If there are no eggs, there is nothing for the sperm to fertilize, and in turn, no chance for conception. This issue does not mean it’s impossible to have a child. There is still a chance of becoming pregnant, even if there are irregular periods.

If pregnant, there are other dangerous effects bulimia can have on both mother and child, including:

• high blood pressure in mother
• gestational diabetes
• complications with birth (i.e., breech, premature, miscarriage)
• high risk for cesarean delivery
• low birth weight baby or risk of stillbirth
• risk of congenital disabilities in the baby
• postpartum depression
• difficulty in breastfeeding

While it may seem the effects on the reproductive system are limited to females, this is not always the case. Bulimia affects male reproductive health as well.

Men’s constant bingeing and purging can cause the body not to absorb the nutrients it needs. This issue could lead to poorer sperm performance and decreased fertility.

Additionally, when the male body experiences abnormally low fat levels, it can lead to lower testosterone and other similar hormone levels that are critical in reproductive functions. Lower hormone levels lead to a poorer sperm count and, in many cases, a lower libido. Lower libidos can cause erectile dysfunction.

Now to the more outward effects of bulimia – the effects bulimia has on the integumentary system.

Bulimia’s Effects on The Integumentary System

Again, when it comes to bulimia’s effect on the integumentary system, many of the problems revolve around a lack of nutrition and dehydration from bingeing, purging, and laxative misuse.

The integumentary system includes hair, skin and nails, and dehydration can severely affect all of these.

If too much water is lost, hair follicles could dry, resulting in dry or curly hair.

If your skin loses moisture, it loses elasticity, so you have more fine lines and easier wrinkles. In addition, your nails can become brittle when there is a lack of proper moisture or nutrition, and they can break off with ease.

Other effects around the face can include a reddish rash or broken veins on your face from the constant strain of vomiting. Similarly, regular use of your fingers to induce vomiting could result in a skin condition called Russell’s sign, where the finger’s joints are callused or off-color.

The Center • A Place of HOPE: Reverse the Effects of Bulimia on the Body

Bulimia is a damaging and debilitating disease with serious long-term challenges.

This guide outlined many consequences of bulimia if left untreated. But there is still a chance to reverse or slow down the side effects of bulimia if you seek treatment. Bulimia is a degenerative disease by its very nature. Constant, guided therapy can give you, or someone you know, hope to face bulimia and overcome it.

If this is the case, we urge you to, contact us today. We have the care and expertise you need to experience recovery.

Call or visit our website for more information about this debilitating disease and seek help.

[1] https://pubmed.ncbi.nlm.nih.gov/18164737/
[2] https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2752386#yoi190065r5
[3] https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2752386#yoi190065r5