Bulimia nervosa is a serious eating disorder whose long-term effects should not be overlooked. Persons with bulimia will eat a large among of food and then rid their body of the food through self-induced vomiting or the use of laxatives or diuretics. They may also restrict calories through fasting or excessive exercise to make up for the periods of binging.1

Researchers estimate that roughly 1.5% of women will develop bulimia in their lifetime, but men can develop the disorder as well.2 Roughly 50% of women will recover from bulimia within ten years of their diagnosis, but an estimated 30% of these women will experience a relapse of the disorder.3 These behaviors can wreak havoc on the body both in the short-term and the long-term. Therefore, it’s important to seek continued medical and nutritional support in addition to mental health treatment after recovering from the disorder.

Short-Term Effects

The short-term effects of bulimia are numerous.4 People may experience amenorrhea, which is the absence of menstruation, or anemia, which can lead to fatigue. Severe dehydration, constipation, and irregular heart rhythms known as arrhythmias can also occur. They may also suffer from changes in their electrolyte levels which can affect organ health. Other effects can include cavities, gum disease, intestinal problems, hair loss, dry skin, sleep problems, stroke, and organ failure.  Due to this intense damage to the body, people with bulimia are at risk of death if they do not seek treatment.

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Long-Term Effects

Many of these short-term effects will dissipate once a person recovers from bulimia and receives proper medical care. However, a person is still at risk for having health complications in the long-term due to the period of poor nutrition. The severity of these effects depends on the intensity of the disorder and how long it persisted.

Diabetes

People with bulimia have a tendency to binge on foods that are high in sugar and fat and low in protein. Even though they purge the food, some will remain in the body, which can cause high blood sugar levels and sometimes the development of diabetes mellitus type 2.5 Women with diabetes are also at increased risk of developing bulimia, as their condition requires them to focus more on their nutrition than the average person.

Brittle Bones

Calcium deficiency during adolescence or young adulthood can cause bone health problems later in life. Women who experience bulimia may have lower than average bone density, particularly if they experienced amenorrhea and higher calcium deficiency during the disorder.6 Women who have both bulimia and anorexia are at a particularly increased risk for osteopenia. Improved nutrition after bulimia can improve bone health, but women are still at increased risk of osteopenia and osteoporosis later in life.

Reproductive Difficulties

Women with bulimia are at risk for infrequent menstrual periods, known as oligomenorrhea, due to poor nutrition. This can affect fertility. It may take some time, but after recovering from bulimia, women will begin to see their menstrual cycle return to normal and they can conceive.7 However, during pregnancy women with a history of bulimia are at risk for relapse as they begin to focus on their weight.Other long-term effects of bulimia can include dental problems, high cholesterol, and damage to the esophagus.

How to Talk to Your Doctor

If you have a history of bulimia, it’s important to talk to your doctor so that they can help you monitor for long-term health risks. Physicians can help you evaluate whether you’re at risk for osteoporosis, diabetes, high cholesterol, or other conditions. If you’re planning to conceive, it’s important to talk to your OB-GYN about the risk of relapse as you gain weight during the pregnancy. Because relapse is common among people with bulimia, the more informed people you have on your medical team, the better your long-term health will be.

If you are currently struggling with bulimia, help is available. Recovery includes a combination of medical attention and nutritional planning to counter the effects of poor nutrition and purging. Mental health treatment is also vital component, to address potential co-occurring illness like depression or anxiety and to help a person identify and challenge negative thought patterns and environmental influences that contributed to the eating disorder behaviors.

Many people successfully recover from bulimia and go on to live full and healthy lives.

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Last Updated: Nov 25, 2018