Understanding The Longterm Effects Of Bulimia

Bulimia is an eating disorder where the person who has it binges or seriously overeats, then purges all of the food they've consumed by vomiting or using laxatives. This binge-purge cycle is what defines bulimia, and it may happen several times a week or even several times a day. Something that most people who have bulimia have in common is that they aren't focusing on the long-term effects of bulimia. In many cases, people with bulimia and the people around them don't even know about the long-term effects or how bulimia can be life-threatening if left untreated.

When doctors and recovery professionals talk about the side effects of eating disorders, they're often talking about the short-term dangers. While those effects are real and serious, there can be a mistaken impression that once someone is on the road to bulimia recovery, their bodies will bounce back. Unfortunately, the effects of bulimia can last long past the acute stage of the disorder. Bulimia can have serious long-term effects on your physical, mental, and emotional health.

Physical effects of bulimia

The repeated act of overwhelming your stomach with binge eating excessive food quantities and regurgitating it back through your esophagus can injure your organs and cause significant disruptions to not just your digestive system, but other associated systems, as well.

1) Heart damage

When your body doesn't have enough calories to burn, it starts consuming muscle to survive. The heart is the most important muscle in the body, and long-term malnutrition can weaken your heart. Since a weak heart can't pump blood as effectively, long-term effects from bulimia can include low blood pressure or heart palpitations. The long-term effects of eating disorders like bulimia can lead to cardiac arrest.

Severe weight fluctuations from bulimia can also damage your heart and weaken its walls. A 1991 study in the New England Journal of Medicine found that both men and women whose weight fluctuated significantly were more at risk of coronary disease and heart disease-related death.

2) Teeth damage

One of the most common long-term bulimia side effects is tooth damage and decay. Regular vomiting from bulimia can erode the enamel of your teeth, causing decay, damage, and even tooth loss. Gum disease and long-term damage of the salivary glands in your mouth (the ones that produce saliva) are also potential effects from bulimia. Though tooth decay and gum disease are rarely fatal, they can be extremely painful and require very expensive dental procedures to fix or mask.

3) Effects and damage to the gastrointestinal (GI) tract

Unsurprisingly, damage of your GI tract is the most prevalent long-term side effect of bingeing in bulimia. Because repeated vomiting weakens the muscles that are supposed to keep your food in your stomach, many people who have bulimia also experience effects like acid reflux.

Sometimes an individual with bulimia may purge using laxatives instead of vomiting. Overusing laxatives can damage the nerve endings in your intestines and anus, making it difficult to go to the bathroom normally. Chronic constipation, along with tooth decay damage, is another one of the most common effects of eating disorders like bulimia and can carry on even after the laxative use has stopped. Overusing laxatives can also damage the blood vessels in the anus. When this happens, the person with bulimia may develop hemorrhoids. While hemorrhoids can be treated over the counter, they can also require prescription medication, ligation, or surgery and be very painful.

4) Kidney damage

People with bulimia are often dehydrated, which can cause long-term damage of the kidneys. Those with bulimia are also at a significantly greater risk for kidney stones and kidney failure. Over the long term, if the individual's kidneys start to fail, they may require dialysis or a kidney transplant.

5) Throat damage

Have you ever had a sore throat after throwing up? That is because of the stomach acid that comes up when you vomit, which irritates the tissues and lining of your esophagus. Repeated vomiting, which can happen with bulimia, can irritate the esophagus to the point that a person can develop esophagitis, an inflammation of the esophagus that can result in scarring. As we discussed earlier, bulimia can cause acid reflux. When acid reflux is recurring or chronic, it is called gastroesophageal reflux disease or GERD. In the worst-case scenario, GERD can result in not only esophagitis but also a rare type of esophageal cancer.

6) Damage to the metabolism

In bulimia, like in other eating disorders, the body doesn't get as much nutrition and calories as it requires to function optimally. Because the body is designed to keep you alive, your metabolism slows down, causing your body to burn fewer calories day-to-day. This usually endures past the time that people with bulimia begin eating more regularly, which causes weight gain. This phenomenon can be very stressful and emotionally damaging to someone who has battled an eating disorder like bulimia.

7) Fertility problems

One of the most emotionally damaging long-term physical effects is the effect bulimia can have on fertility. The malnutrition that comes with bulimia often impacts the production of sex hormones. Women  with bulimia might miss periods as the body shuts down non-essential functions, which can affect long-term fertility. Both men and women with bulimia may discover their infertility when they begin to try to have children.

8) Other issues

Additionally, according to the National Institutes of Health, bulimia can cause abnormal levels of serotonin and tryptophan in the body, which can cause "a disruption in both the acute and longer-term mechanisms controlling hunger and satiety." In other words, because bulimia disrupts the chemical levels of your body, people with bulimia may have long-term difficulty determining if you are hungry or full.

Due to sustained levels of malnutrition, people recovering from bulimia may experience low bone density later in their lives, which can lead to fragile and broken bones as they grow older. They are particularly susceptible to this issue because bulimia often develops around puberty when the teen body and skeletal system are still developing.

Finally, according to the National Eating Disorder Association, "over time, binge eating can potentially increase the chances that a person's body will become resistant to insulin, a hormone that lets the body get energy from carbohydrates, which can lead to Type 2 diabetes."

Mental and emotional effects of bulimia

Both bulimia nervosa and other eating disorders have serious long-term mental and emotional effects. Long-term malnutrition can alter the chemical balance of the brain, leading to mental health issues like clinical depression and anxiety. This risk is made more serious because, as mentioned, bulimia often arises during the teen years while the body and brain are still developing.

Eating disorders like bulimia can additionally damage relationships and self-esteem. According to the National Institutes of Health, "mood and anxiety symptoms are very common. These symptoms of low self-esteem and body image disturbance can all have a negative effect on social relationships, which in turn may be damaged by a lifestyle that may be chaotic and characterized by impulsivity." Low self-confidence, a weak support system, and susceptibility to depression or anxiety can sometimes lead to issues like self-harm, substance use, and suicidal thoughts or tendencies. If you or someone you know is experiencing suicidal thoughts, help is available. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255 and is available 24/7, or you can text the word “HOME” to 741741 to reach the Crisis Text Line.

Seeking treatment for bulimia nervosa

There are many negative long-term side effects of bulimia, which can range from irritating to life-threatening. Some of the mental and physical effects can last long past the time when the individual with bulimia has technically recovered, negatively impacting their quality of life.

The best way to manage the long-term side effects of bulimia is to get professional treatment as soon as possible. The sooner bulimia treatment begins, the more likely you are to minimize the long-term damage. Since the person experiencing bulimia often tries to hide their bulimia for as long as possible, the first step is to recognize that the problem exists.

In the face of bulimia, family and friends can feel helpless and unsure of what to do. If you don't know where to start, you can reach out to a licensed and certified mental health professional at BetterHelp.com.

Even if the person experiencing bulimia isn't ready or refuses to get treatment, one of the online counselors at BetterHelp can help you learn more about what the person's going through and how to talk to them about bulimia. Recovering from bulimia and preventing long-term complications can require the whole family, and it is best to start the process of recovery as soon as possible. 

Online therapy as a tool for bulimia recovery

One of the main reasons online therapy may be advantageous for someone living with bulimia is that it reduces the need to go to an in-person therapist’s office for treatment. People who have bulimia may feel the weight of the stigma associated with engaging in behaviors that others may find perturbing, though there is nothing to be ashamed of – bulimia is a disease. Online therapy allows you to schedule appointments from your own space, which may encourage you to be more open in your discussions with your therapist.

Online therapy has also been proven effective in helping many people heal from bulimia nervosa. In a study investigating how online cognitive behavioral therapy (CBT) could impact the recovery process of people with bulimia, researchers found promising results. Participants experienced improved symptoms after completing various homework assignments, such as keeping activity diaries, rating their moods, and engaging in semi-structured interviews with their clinicians.

Just like a face-to-face counselor, an online therapist will emphasize that the bulimia recovery process is not linear. They can be instrumental in helping you identify triggers which may influence you to initiate bulimia binge cycles and pose questions to help you consider how those triggers came about. Additionally, they can collaborate with you to determine healthier coping mechanisms. You can read a couple of counselor reviews below from people who have sought treatment for bulimia through the online therapy platform BetterHelp.