Long-term effects of bulimia: The impact of eating disorders on health

Key Points

• Bulimia is an eating disorder characterized by binging and purging.
• Over time, bulimia can lead to severe physical and mental health consequences.
• With effective bulimia treatment, it is possible to reverse most of the long-term effects of bulimia.

Bulimia is a serious eating disorder where a person binges by eating a lot of food in a short period and then compensates by purging. Purging behaviors include self-induced vomiting, the misuse of laxatives or diuretics, and excessive exercise.

The long-term medical complications of bulimia include malnutrition and damage to the digestive system, circulatory system, bones, teeth, heart, kidneys, cholesterol levels, blood pressure, fertility, and more.

Health consequences of purging include weak muscles, fatigue, and electrolyte imbalances that can lead to heart problems. This article explores the long-term effects of bulimia on the body.

1. Digestion and gut health

According to Gia Eapen, MD, an OB/GYN physician, "Binging and purging can seriously damage the oral and digestive system in many ways. Repeated self-induced vomiting brings stomach acid into contact with the teeth, eroding the enamel. This protective layer wears down over time, making teeth sensitive to hot and cold foods. Stomach acid can also lead to gum disease, mouth ulcers, and tooth decay."

Chronic exposure to stomach acid can harm the esophagus, sometimes causing Mallory-Weiss tears that result in bleeding. Vomiting frequently can also cause the salivary glands to swell, creating puffy “chipmunk” cheeks.

Another visible effect of purging is the presence of callouses on the knuckles caused by friction with the teeth during vomiting. Laxative abuse, another form of purging, carries risks such as heartburn, constipation, acid reflux, and hemorrhoids from straining. These behaviors can have long-lasting medical complications.

2. Reproductive health

Binge eating and purging can cause fatigue, which may lower a person’s sex drive. Additionally, with bulimia, the habit of extreme dieting or restricting food intake followed by binge eating and purging can lead to weight gain and hormonal imbalances.

People with bulimia can experience missed or skipped periods. If the eating disorder begins before puberty, it can delay the onset of periods. Females with bulimia nervosa are also at a greater risk of developing polycystic ovarian syndrome (PCOS), a leading cause of infertility.

Says Eapen, MD, "Bulimia nervosa and other eating disorders may affect fertility, but with effective treatment, many women can have healthy pregnancies."

3. Chronic conditions

An eating disorder like bulimia can raise the risk of type 2 diabetes. This is because the act of binge eating may impact how fat is stored and processed in the body. This can affect how insulin works, leading to type 2 diabetes.

Studies show a link between bulimia and type 1 diabetes, a condition where the body doesn’t produce enough insulin. People diagnosed with type 1 diabetes are often at a lower weight before starting insulin, which can lead to weight gain.

For some, this impacts self-esteem and body image, causing them to skip or avoid insulin to lose weight. This behavior, known as diabulimia, can result in dehydration, malnutrition, muscle loss, and even life-threatening complications.

People with bulimia have a greater risk of developing kidney stones due to frequent dieting and purging, which disrupt electrolyte balance.

4. Effect on skin, hair, and nails

Bulimia nervosa leads to dehydration, which causes dry hair, skin, and brittle nails. Due to malnutrition, bulimia can also result in hair loss.

5. Effect on bones

People with bulimia can be of any weight, but low bone density is more common in those with lower body weight. This happens when the body doesn’t receive enough nutrients to maintain healthy bones. Over time, this can lead to brittle bones and an increased risk of fractures.

6. Sleep problems

Bulimia can disrupt sleep patterns and lead to more health issues. Many people with bulimia have difficulty falling or staying asleep. Over time, insufficient sleep can cause nighttime cravings, which may trigger binge eating. These cravings make it even harder to get quality rest and can even trigger the binge-purge cycle.

Poor sleep doesn’t just cause tiredness. It can lead to daytime sleepiness, brain fog, and trouble focusing. Low energy and sadness are also common. Sleep deprivation also weakens the immune system, raising the risk of infections.

Over time, it may even raise the chance of developing type 2 diabetes. Treating sleep problems is key to breaking this cycle and improving overall health.

Treating the long-term effects of bulimia

Eapen MD notes, "Bulimia can be treated, and many of its effects can be reversed. While chronic conditions cannot be cured, they can be managed through lifestyle, exercise, and medication when necessary. The first step to reverse the effects of bulimia is to seek treatment from eating disorder experts."

Bulimia treatment involves a team of eating disorder specialists, including a mental health professional, a registered dietitian (RD), and physicians. Effective treatment is tailored to meet each individual's needs.

Additional FAQs

How long does it take to develop health complications from bulimia?

The more immediate or short-term health effects of bulimia include dehydration and electrolyte imbalances from frequent purging. Self-induced vomiting and laxative misuse can cause digestive issues like constipation, diarrhea, and acid reflux. 

These symptoms could take a few weeks to a few months to develop. 

Can the physical effects of bulimia be reversed?

On the positive side, most of the effects of bulimia can be reversed with treatment. This is when the binging and purging behavior stops, and a healthy weight is maintained. 

Some physical effects may remain but can be managed to prevent them from getting worse. For example, the enamel is a protective coating on the teeth that cannot grow back once it’s destroyed.

Another example is the impact of bulimia on the heart. Many cardiovascular issues can be reversed or improved during treatment. The conditions that are permanent can be managed and prevented from getting worse.

Is treatment still necessary if symptoms are mild?

Yes, getting help early lowers your risk of developing serious health conditions and breaking free from the vicious cycle of binging and purging. 

Timely psychotherapy, antidepressants when needed, and nutritional counseling can help you reclaim a healthy life. 

What should I do if I suspect someone has bulimia?

If you suspect someone you know has bulimia, it is very important to approach them with sensitivity. First, read up about the condition and its effects, and learn how a person with bulimia may feel helpless against the voice of the eating disorder in their head.

When discussing the topic of bulimia with them, do not criticize, blame, or shame them. Do not confront them in a social setting. Instead, offer reassurance that you are a source of support.

An eating disorder is a serious mental health condition and is often accompanied by other mood disorders like depression, anxiety, and more. Consider reaching out to professionals to help you understand how to talk to someone who may have bulimia.

Get bulimia treatment at your doorstep, covered by insurance.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.