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Medical Complications of Bulimia Nervosa

How Bulimia Affects Your Body


Updated September 30, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

By definition, people struggling with bulimia nervosa engage in binge eating and purging episodes. Binge eating occurs when someone eats a greater than normal amount within a small time frame. This may include many, many calories. The purging may include self-induced vomiting, laxative use, enemas, and/or excessive exercise. Depending on the duration of the illness, the frequency of binge & purge episodes and what type of purging the sufferer engages in, medical complications often arise. Not all people with bulimia will experience all or even some of these complications. However, the longer a person goes without entering treatment and recovery, the more likely they are to experience serious physical problems as a result of the disease. There are many organ systems that are impacted by bulimia, some are listed below.

A common problem that is often noticed by loved ones is a swollen look to the face, caused by swollen and tender parotid glands located on the sides of the face near the ears. Vomiting can also cause blood vessels to burst in the eyes, causing a bloodshot look.

Skin and Hair Problems

Many people with bulimia complain of hair loss and dry skin, which is caused by not getting enough nutrients. If the person engages in self-induced vomiting, they may also have erosion of the enamel on their teeth or develop a thickened skin on the back of their hand. This thickened skin is called "Russell's sign." Unfortunately, the erosion of dental enamel and the thickened skin can be permanent problems.

Dentists can advise sufferers and those in recovery to what extent there is damage to their teeth, how to prevent further damage (washing their mouth out after vomiting), and if repair is necessary. This erosion can cause sensitivity to cold/hot foods and drinks. Frequent vomiting can trigger gum disease.

Gastrointestinal Problems

Although rare, frequent vomiting can, over time, cause tearing in the surface of the esophagus. Besides being painful, this may cause blood to be vomited up and eventually could result in esophageal rupture.

If a person has been abusing laxatives, they may experience significant problems after stopping their use including constipation and abdominal discomfort. If you are attempting to stop using laxatives, talk with your treatment team about what to expect and what you can do to minimize negative symptoms during the withdrawal. If bloating and abdominal pain occur for a long period of time, your doctor may want to do an abdominal x-ray for further evaluation.

Cardiovascular (Heart) Problems

Cardiac problems can occur in bulimia. Purging can cause in electrolyte abnormalities that may lead to heart arrythmias and even sudden death.

Endocrine Problems

The endocrine system is also affected by bulimia as reproductive hormones may be disrupted.

If you, or someone you know is suffering from bulimia, please seek treatment. The longer that bulimia is left untreated, the more likely you are to experience medical complications. Unfortunately, the complications of bulimia can sometimes occur suddenly and become deadly.


Costin, C. (2007). The eating disorder sourcebook (3rd Ed.). New York, NY: McGraw Hill.

Mehlher, P.S., Birmingham, L.C., Crow, S.J. & Jahraus, J.P. (2010). Medical Complications of Eating Disorders. In C.M. Grilo & J.E. Mitchell (Eds.), The treatment of eating disorders: A clinical handbook (66-82). New York, NY: The Guilford Press.

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