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Characteristics of Bulimia Nervosa Continued

Bridget Engel, Psy.D., Natalie Staats Reiss, Ph.D., and Mark Dombeck, Ph.D.

Health Problems

The medical complications related to bulimia are very serious. Many of the physical side effects are the result of chronic vomiting. Frequent vomiting causes infected and swollen salivary glands, stomach ulcers, reflux disease, broken blood vessels, and sore cheeks. Bulimics can experience lung aspiration (inhaling foreign matter, typically vomit, into the lungs), which causes damage to lung tissue, pneumonia, shock, and/or respiratory disease. Tearing or rupturing of the esophagus and stomach can also occur due to the pressure of binge eating and vomiting, causing serious, life-threatening medical problems. Also, a metabolic imbalance called alkalosis (an imbalance of pH levels in the blood and body fluids), causes symptoms ranging from slowed breathing to coma. Furthermore, gum disease, tooth enamel erosion and sensitivity to hot and cold can result. Many individuals with bulimia have skin abrasions on their knuckles from inducing vomiting.

The use of laxatives and diuretics has long-term and serious side effects. Constipation, dehydration, diarrhea, bloating, abdominal cramping, hemorrhoids, and irregular bowel movements are not uncommon. Some of these symptoms may take a long time to alleviate once treatment begins.

Insufficient vitamins and minerals in the diet and severe weight loss cause abnormalities in electrolyte levels. As mentioned in the section on anorexia, electrolytes are electrically charged chemicals in your blood and cells that help to keep your heart and body functioning properly. Imbalances in electrolytes can cause fatigue, overall weakness, confusion, decreased concentration, and even seizures. Electrolyte problems and hormone imbalances can also lead to insomnia (impaired sleep). Hypokalemia is a deficiency in potassium that causes diminished reflexes, fatigue and cardiac abnormalities.

Heart problems are the leading cause of death among bulimic patients. Many individuals with bulimia experience dizziness, irregular blood pressure, and abnormal heart beat.