Can bulimia kill you?

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Bulimia nervosa (BN) is a serious eating disorder that affects up to 4.6% of women and 1.3% of men during their lifetimes. (1) Transgender men, transgender women, as well as those who are non-binary are affected as well. Unfortunately, people with Bulimia nervosa are at risk of numerous health problems. This leads some people to wonder, “can bulimia kill you?” The health problems that occur with bulimia, combined with the mortality rate of this eating disorder, provide answers to this question.

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In this article

Health problems linked to bulimia

Binging and purging behaviors associated with bulimia increase the risk of numerous health problems, some of which can be serious. Based upon the available research, individuals with bulimia are more likely to experience the following health conditions. (2)

Medical problems from purging

Repeated self-induced vomiting is linked to chronic acid reflux, which can also lead to indigestion and difficulty swallowing. In many instances, acid reflux is mild and non-fatal, but in severe cases, purging can cause serious damage to the esophagus, leading to lesions on the esophagus, bleeding, and ulcers, and in rare cases, esophageal rupture. (3) Esophageal rupture is less common, but it can be fatal. Many of the other side effects of vomiting, including acid reflux, mostly lead to discomfort from sore throat and heartburn. 

While acid reflux can be uncomfortable, one of the most serious medical problems associated with vomiting is an electrolyte imbalance, which occurs from a disruption of the life sustaining balance of electrolytes like potassium, sodium, and phosphorus. Low potassium levels can lead to cardiac arrhythmias, which can be fatal. 

Keep in mind that vomiting is not the only form of purging that can occur in people who live with bulimia. Some people may abuse laxatives, which can also lead to electrolyte imbalances and a condition called metabolic alkalosis, which can cause cardiac arrhythmia and reduced blood flow to the brain. (4) Excessive laxative abuse can also cause diarrhea, hemorrhoids, rectal prolapse, severe constipation, and laxative dependence. (2)

Oral health problems

Bulimia side effects are associated with numerous oral health problems, including swelling of the salivary glands and the development of the gum disease, known as gingivitis. Vomiting can also lead to cavities, enamel loss, and a more serious gum disease called periodontitis. (3)

Periodontitis is caused by infection and inflammation in the gums and in the bones around the teeth. Severe or untreated periodontitis can lead to tooth loss. (5) While gum disease may seem relatively mild, it can be severe in some cases. For example, among people with diabetes, periodontitis is linked to an increased risk of nerve damage, cardiovascular problems, kidney disease, and death. These health problems are a result of the inflammation that occurs with periodontitis. (6)

Psychiatric problems

A study of over 3,000 patients admitted to the hospital for treatment of bulimia found that depression and psychosis were common among these patients. (7) Unfortunately, individuals with bulimia are at increased risk of dying by suicide. (8) Sometimes death from bulimia is not a result of medical complications but rather is due to the devastating psychological impact of bulimia.

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Can bulimia kill you? The bottom line

Bulimia is an eating disorder that is associated with both medical problems and co-occurring mental health disorders like depression. Some medical problems are a direct result of the purging behaviors that occur with bulimia, and while they are not always fatal, the truth is that they can be. 

Given the health problems that occur alongside bulimia, there is an increased risk of death among people who live with this eating disorder. Research has shown that the crude mortality rate of bulimia is 3.9% over the long term. (8) The answer to the question, “can bulimia kill you?” is, in some cases, yes, especially if the condition is left untreated.

The good news is that treatment can reverse many of the medical complications associated with bulimia and reduce the risk of serious medical complications, including death. Effective eating disorder treatment is available, and it can help you to repair your relationship with food and overcome eating disorder symptoms. Reach out today to begin healing your body.

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.

Resources

  1. van Eeden, A.E., van Hoeken, D., & Hoek, H.W. (2021). Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Current Opinion in Psychiatry, 34(6), 515-524. https://doi.org/10.1097/YCO.0000000000000739
  2. Westmoreland, P., Krantz, M.J., & Mehler, P.S. (2016). Medical complications of anorexia nervosa and bulimia. The American Journal of Medicine, 129(1), 30-37. https://doi.org/10.1016/j.amjmed.2015.06.031
  3. Mehler, P.S. (2011). Medical complications of bulimia nervosa and their treatments. International Journal of Eating Disorders, 44(2), 95-104. https://doi.org/10.1002/eat.20825
  4. Brinkman, J.E., & Sharma, S. (2022, January). Physiology, metabolic alkalosis. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK482291/
  5. Eke, P.I., Dye, B., Wei, L., Thornton-Evans G., & Genco R. (2012, August 30). Periodontal disease. Centers for Disease Control and Prevention. https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html
  6.  Nguyen, A., Akhter, R., Garde, S., Scott, C., Twigg, S.M., Colagiuri, S., Ajwani, S., & Eberhard, J. (2020). The association of periodontal disease with the complications of diabetes mellitus. A systematic review. Diabetes Research and Clinical Practice, 165, 1-10. https://doi.org/10.1016/j.diabres.2020.108244
  7. Patel, R.S., Olten, B., Patel, P., Shah, K., & Mansuri, Z. (2018). Hospitalization outcomes and comorbidities of bulimia nervosa: A nationwide inpatient study. Cureus, 10(5), e2583. https://doi.org/10.7759/cureus.2583
  8. Crow, S.J., Peterson, C.B., Swanson, S.A., Raymond, N.C., Specker, S., Eckert, E.D., & Mitchell, J.E. (2009). Increased mortality in bulimia nervosa and other eating disorders. The American Journal of Psychiatry, 166(12), 1342-1346. https://doi.org/10.1176/appi.ajp.2009.09020247

FAQs

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