Examining the bulimia death rate

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Eating disorders are among the most dangerous—and deadly—diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Even if they don’t directly lead to death, eating disorders like bulimia nervosa (BN) can cause many health problems for people struggling with them. 

Despite these grim statistics, it’s important to remember, if someone can find the help they need, there’s hope of making a full recovery.

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In this article

By the numbers

Statistics on eating disorders are gathered independently by separate institutions, through different reports and studies, so universal numbers are difficult to come by—including the lethality for various disorders.

One 2016 study conducted in Germany found a death rate of 1.49 for bulimia nervosa, meaning people struggling with the disorder were 1.49 times more likely to die than those without the disorder. (1) 

Meanwhile in the United States, a 2009 study—one of the most recent and widely-cited on the topic—uncovered a death rate of 3.9 for people struggling with bulimia, which came in second only to anorexia nervosa (AN) in terms of deadliest mental illnesses. (2)

The disparity may be explained by several factors: The studies were conducted at different times, using different data sets. (The 2009 study proclaimed the bulimia death rate as an “increase” at the time.)

Eating disorders as a whole have also historically been more prevalent in the United States than the rest of the world, due to being diagnosed at higher rates, though, sadly, it seems some countries, especially in areas of Asia, are beginning to catch up. (3)

Perhaps the biggest difference in the statistics, however, is how the deaths were classified. Bulimia nervosa can, and does, directly lead to people dying, but the disorder is also linked to a number of other conditions that may lead to death or serious impairment.

Other complications

Several major components of bulimia nervosa make the disorder particularly harmful: the harsh mechanics of its purging methods and the often deeply-seeded comorbid mental health struggles that frequently co-occur.

For those who purge through self-induced vomiting, many systems within the body can be thrown off, sometimes fatally. This action can lead to serious electrolyte imbalance, which frequently leads to heart failure. (4) It can also cause serious gastric ruptures or ruptures along the esophagus, which can be deadly or at the very least extremely painful and difficult to manage. (4) 

Similarly, those who misuse laxatives as a form of purging are in danger of developing chronic bowel problems, which can snowball into further health complications. (4)

Perhaps the most prevalent complication is mental health related . Rates of depression for people struggling with bulimia have been reported as high as 70%. (5) Other statistics show people with bulimia are also diagnosed with an anxiety disorder 80% of the time, and with a substance use disorder 36% of the time. (6) 

All this has, unfortunately, led to an increased risk of suicide for people struggling with bulimia. While many more studies have been conducted studying the connection between suicide and anorexia nerovsa, figures indicate that people with bulimia have as much as a 38% chance of considering suicide over their lifetime and as much as a 23% chance of having current suicidal ideation. And women with the disorder are up to 7 times more likely to die by suicide than women who don’t have the disorder. (7)

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When to seek help for bulimia

All this makes it imperative for someone struggling with bulimia to seek help—and help is truly possible.

In fact, bulimia nervosa has one of the highest recovery rates among eating disorders, with one study finding as many as 62.8% of participants making a full recovery. (8) 

Seeking treatment as early as possible is especially important, for several reasons. 

Compulsive eating is often a major factor in bulimia, and the longer that type of behavior is allowed to persist, the more difficult it becomes to eradicate from someone’s daily routine.

Additionally, the longer someone struggles with bulimia, the more likely it is they will develop physical complications and even be at risk for premature death.

Bulimia can impact anyone at any time in their life, and everyone struggling deserves competent care and support. If you struggle with bulimia nervosa or suspect someone you know may be struggling, it’s important to seek the appropriate type of treatment as quickly as possible. Reach out to our team today to learn about how to get started.

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.


  1. Fichter, M. M., & Quadflieg, N. (2016). Mortality in eating disorders - results of a large prospective clinical longitudinal study. International Journal of Eating Disorders, 49(4), 391–401. https://doi.org/10.1002/eat.22501 
  2. 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. American Journal of Psychiatry, 166(12), 1342–1346. https://doi.org/10.1176/appi.ajp.2009.09020247 
  3. McGuire, J., & McGuire, J. (2021, February 22). Eating disorders on the rise all around the world: An overview. Eating Disorder Hope. Retrieved April 17, 2022, from https://www.eatingdisorderhope.com/blog/eating-disorders-world-overview 
  4. Signs and symptoms of bulimia nervosa. Within Health. (n.d.). Retrieved April 17, 2022, from https://withinhealth.com/learn/signs-and-symptoms-of-bulimia-nervosa 
  5. Depression and eating disorders. Eating Disorder Hope. (2021, December 3). Retrieved April 17, 2022, from https://www.eatingdisorderhope.com/treatment-for-eating-disorders/co-occurring-dual-diagnosis/depression 
  6. U.S. Department of Health and Human Services. (n.d.). Eating disorders. National Institute of Mental Health. Retrieved April 17, 2022, from https://www.nimh.nih.gov/health/statistics/eating-disorders 
  7. Lauren Muhlheim, P. D. (2021, April 29). How to get help when you have an eating disorder and are suicidal. Verywell Mind. Retrieved April 17, 2022, from https://www.verywellmind.com/eating-disorders-suicide-4174291 
  8. ScienceDaily. (2016, December 20). Given time, most women with anorexia or bulimia will recover. ScienceDaily. Retrieved April 17, 2022, from https://www.sciencedaily.com/releases/2016/12/161220140917.htm


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