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It’s common for individuals with bulimia nervosa (BN) to experience headaches. One study shows that 75 percent of women with anorexia nervosa or bulimia nervosa experience regular migraines, compared to the 12.5 percent of the population that have them. (7) The idea that people with an eating disorder are more prone to bulimia nervosa headaches makes sense when looking at the common causes of headaches, such as dehydration, stress, and depression.
Dehydration typically causes bulimia nervosa headaches. Dehydration is a common symptom of BN. It occurs when the body loses more fluids than it takes to function correctly. In severe cases, dehydration can cause the body’s organs to shut down because of the loss of electrolytes, including chemicals like sodium and potassium. The body uses electrolytes to maintain fluid balance in blood vessels and organs. (2)
Many people with bulimia nervosa experience headaches because of purging behaviors. People can lose fluids when they vomit or use diuretics. Individuals with BN can also eliminate too many fluids by sweating through excessive exercise or daily urination. When the body is dehydrated, the brain contracts or shrinks. As it contracts, it pulls away from the skull, putting pressure on the nerves. This pressure is what leads to pain and discomfort in headaches. (3) Even mild dehydration can lead to headaches, so even if a person drinks water during or after purging, it may not be enough to replace what was lost, leading to a prolonged headache.
In addition to dehydration, someone with BN may experience headaches because of low blood sugar. The body needs food to fuel itself. When a person with bulimia nervosa purges, they rid their body of nutrients which can cause blood sugar levels to drop. When a person’s blood sugar gets too low, it releases a hormone to tell the brain it's hungry. This hormone can also tighten blood vessels and increase blood pressure, which may cause headaches. (4)
What causes headaches during bulimia nervosa treatment and recovery?
It is possible to experience bulimia nervosa headaches while undergoing recovery and treatment, even if an individual is eating and drinking more regularly and purging less. It can take time to refuel and hydrate the body in BN recovery, so it’s not uncommon for headaches to persist.
It’s also possible for headaches to develop during recovery that is not because of dehydration or hunger. Stress is a common trigger for headaches, including migraines and tension headaches. (5) Bulimia nervosa treatment can be challenging and may feel stressful at times. During these high-stress moments, an individual may also experience a lack of appetite, leading to more head pain.
Headaches are also a symptom of depression, which often coexists with bulimia nervosa. (6) Throughout bulimia nervosa recovery, an individual may continue to live with depression and experience depression symptoms, including headaches.
The symptoms of a bulimia nervosa headache may vary depending on the underlying cause. If a person is experiencing a tension headache, often from stress, the head pain can range from mild to moderate and may come with neck or muscle pain. Dehydration or hunger headaches can cause confusion, fatigue, dizziness, dry mouth, increased heart rates, or high blood pressure. (1) The pain associated with migraines may feel more intense and cause sensitivity to light and noise. Migraines also last longer than other headaches, sometimes up to multiple days.
Headaches can feel debilitating. Sometimes the pain is so severe, making it difficult to do much else. Living with bulimia nervosa headaches during recovery and treatment can make completing the necessary steps more challenging.
Working through the pain of bulimia nervosa headaches does not have to be a process done alone. Within Health offers revolutionary support for people with an eating disorder to receive clinically superior care at home. The personalized programs offered by Within use the latest technology to provide real-time interactive experiences accessible to everyone, regardless of their shape, size, ethnicity, gender expression, sexuality, or background. Contact our admissions team today to learn more about the Within Health approach to helping individuals heal from bulimia nervosa.
Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.
Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.
Ostuzzi, R., D’Andrea, G., Francesconi, F., & Musco, F. (2008). Eating disorders and headache: Coincidence or consequence? Neurological Sciences, 29(S1), 83–87. https://doi.org/10.1007/s10072-008-0894-5
