Medical Consequences of Bulimia Nervosa

Bulimia nervosa is an eating disorder characterized by frequent episodes of binge eating, or eating a large amount of food in a short period of time, followed by purging by self induced vomiting, use of laxatives, diuretics, excessive exercise, or restricting. 

Bulimia is a serious eating disorder that can cause potentially life-threatening complications. There are many complications in many different body systems that my result from the physical consequences of Bulimia

Face and Mouth

Binging and purging by vomiting can cause noticeable changes in the face and mouth, including:

  • Tooth decay from the strong stomach acids that break down the tooth enamel and gums
  • Tooth sensitivity, cavities, and the need for root canals. 
  • Puffy cheeks may be a sign of swollen glands
  • Red eyes: frequent, forceful vomiting can burst the blood vessels in the eyes
  • Raspy voice and cough: the stomach acid may damage the vocal cords and the ongoing acid irritation can cause coughing. 


  • Weakness in esophageal sphincter
  • Gastroesophageal reflux disease (chronic acid reflux)
  • Tearing of the esophagus (Mallory Weiss Tear)
  • Esophagitis, or inflammation of the esophagus leading to scarring
  • Esophageal Cancer
  • Injury to blood vessels near the anus, causing hemorrhoids 
  • Overuse of diuretics may lower potassium and cause dehydration and cardiac issues
  • Abusing laxatives or diuretics may lead to dependency, making it difficult for the individual to have normal bowel movements 


Vomiting and diarrhea can also cause:

  • Low heart rate
  • Low blood pressure
  • Cardiac arrhythmias, or abnormal heart rhythms
  • Difficulty regulating body temperature 
  • Cardiac Arrest


  • Loss of fluids may occur due to vomiting, over exercising, and/or using diuretics or laxatives
  • Dehydration may lead to extreme fatigue and may cause dangerous electrolyte disturbances, such as low potassium or magnesium 
  • Skin may become extremely dry
  • Hair can turn frizzy, thin, and begin to fall out
  • Nails can become brittle and chip easily 

Hormonal changes in Reproductive System

  • Abnormally low estrogen and progesterone levels could cause females to stop menstruating
  • Loss of sex drive
  • Ovaries may shut down and stop releasing eggs, making pregnancy impossible
  • Low bone density and brittle bones
  • Decrease levels of the reproductive hormones may lead to bone loss and increase the risk of osteoporosis 

Effects on Pregnancy 

Pregnant women who binge and purge put themselves and their babies at risk of significant complications, including:

  • low birth weight
  • miscarriage
  • birth abnormalities
  • premature birth
  • Postpartum depression
About me
Kirsten Book, PMHNP-BC

I support the patient to help them feel empowered in their own recovery.

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