Persons who have bulimia can hide the physical symptoms fairly well most of the time, but that doesn't mean that they aren't there. Bulimia has a profound effect on the body, from the teeth to the bowels.
Bulimia and Tooth Decay
Tooth decay is a common symptom of bulimia. Oral health is hard to maintain when a person is actively purging. Stomach acid (hydrochloric acid) is very powerful and will erode tooth enamel. Without treatment, tooth loss will result. Dentists may be the first to suspect the presence of an eating disorder. They can play significant roles in steering their patients toward the help they need.
Enlarged Salivary Glands
One study (Metzger et al.) compared those with symptoms of bulimia to those who had none and found that in the group with bulimia, salivary glands were on average 36% larger. Further, the more frequent the person engaged in bulimic behaviors, the larger the size of the salivary glands.
Scarred Hands
This comes from repeatedly inserting the hand into the mouth to induce vomiting. Eventually, the back of the hand is irritated by contact with the teeth, and scarring results.
Dehydration
When fluids are forced out of the body, whether by vomiting or laxative use, they should be replenished. This often does not occur for those struggling with bulimia, and dehydration results.
Amenorrhea
Without adequate nutrition, the body cannot support a regular menstrual cycle. The cycle may become irregular or stop completely.
Esophageal Tears
Vomiting puts a great deal of pressure on the esophagus, and in certain cases, it can rupture.
Gastric (Stomach) Rupture
It doesn't happen often, but there are cases in which the stomach is unable to handle the amount of food eaten in a binge and splits open.
Cardiac Arrhythmias
When electrolytes become imbalanced (see below), the body has a more difficult time sending electrical impulses. When the heart doesn't receive normal electrical signals, it can affect the heartbeat's rhythm.
Electrolyte Imbalance
Potassium, sodium, and chloride are forced from the body in purging episodes. These minerals are necessary for health, particularly the function of the heart. In some cases, an electrolyte imbalance can cause heart failure and death. Electrolyte imbalances include the following:
- Hypokalemia (abnormally low potassium): Symptoms can include heart palpitations, cramping, and paralysis.
- Hyponatremia (abnormally low sodium): Symptoms can include fatigue, cramping, and convlulsions.
- Hypochloremia (abnormally low chloride): Chloride helps to regulate sodium level.
Chronic Bowel Problems
For those who eliminate food through laxative use rather than purging, the body can eventually need the laxatives even for normal digestion. Laxative abuse can lead to irregular bowel movements and constipation.
Back to the Major Features of Bulimia Nervosa
Sources:
Hurd, Robert (update). Hypokalemia. MedlinePlus. Accessed 9 January December 2008.
MedicineNet, Inc. Definition of hypochloremia. Accessed 12 December 2006.
MedlinePlus. Hyponatremia. A.D.A.M. Accessed 12 December 2006.
Metzger, Eran D., Jeffrey M. Levine, Colin R. McArdle, Barbara E. Wolfe, and David C. Jimerson. Salivary gland enlargement and elevated serum amylase in bulimia nervosa. Biological Psychiatry 45 (1999): 1520-1522.
National Eating Disorders Association. Bulimia nervosa. Accessed 12 December 2006.
University of Maryland Medical Center. 2005. Bulimia nervosa. A.D.A.M. Accessed 11 December 2006.
