Bulimia nervosa is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating. According to the National Eating Disorder Association (NEDA) at any given point in time, 1.0% of young women and 0.1% of young men will meet diagnostic criteria for bulimia nervosa. That seems significant, yet nobody wants to talk about it.

The human body is resilient in coping with the stress of eating disordered behaviors, and laboratory tests can generally appear perfect even as someone is at high risk of death. Therefore, it’s incredibly important to understand the many ways that eating disorders affect the body.

Electrolyte imbalance

Electrolyte imbalances are a constant risk for those living with BN due to common electrolyte loss resulting from compensatory behaviors. Electrolytes such as sodium, potassium, calcium, and chloride are essential for the body to function at its optimum capacity. If those electrolytes are purged from the body without being adequately replaced, the levels will fall, resulting in a disruption of the body’s delicate balance.

Damage to major organs

The caustic stomach acid present in vomit can irritate the esophagus irritating and sometimes tear. This irritation can result in erosion and damage to the pharynx (throat) and vocal cords, causing a sore throat, difficulty swallowing and a hoarse voice. The salivary glands can also become swollen, causing the cheeks to appear puffy. Excessive vomiting can also lead to an esophagus rupture or tear, causing the contents to spill into the chest and lead to serious lung complications. Esophageal ruptures can cause severe chest pain, vomit containing blood, nausea, rapid breathing, and fever–this is a medical emergency and must be treated immediately with surgery to repair the tear.

Digestive problems

Laxative abuse can disrupt the body’s natural gastrointestinal functioning, causing the intestines to lose muscle tone and leading to a dependence on laxatives to produce a bowel movement. When laxative use stops, that can result in constipation which often causes bloating and an uncomfortable feeling of fullness. Peptic ulcers – sores in the lining of the stomach or the first part of the small intestine – are another problem that can occur. Excessive acid can cause these small breaks in the stomach or duodenum which dissolves the lining in those areas, resulting in painful, bleeding sores.

Neurological effects

There is still much to learn about the impact that eating disorders have on the brain both temporarily and permanently. One thing we do know is that because neurons use electrolytes like potassium, sodium, chloride, and calcium to send electrical and chemical signals in the brain and body, severe dehydration and electrolyte imbalances can lead to seizures and muscle cramps.

Oral problems and tooth decay

Frequent self-induced vomiting behavior can cause staining and erosion due to excess acid build-up in the mouth area. Depending on the frequency and duration of this behavior, teeth can erode so severely that chewing and swallowing can become difficult and necessitate the need for dental repair work or even full replacement or dentures.

There are many other harmful health risks of bulimia nervosa than what we reviewed here–some are reversible, and some are not. Early intervention is critical, so if you or someone you know may be engaging in eating disordered behaviors, we can help. The earlier a person with an eating disorder seeks treatment, the greater the likelihood of physical and emotional recovery.



Jessica Walther is the Director of Marketing and Community Relations at Walden Behavioral Care. Jessica has worked in the eating disorder field for over a decade and has a strong passion for education and advocacy for mental health, specifically eating disorders. She has worn many hats in the eating disorder field over the years and has built relationships on a national level as she works with leaders in the community to help make treatment accessible to everyone.