Is hair loss a symptom of bulimia nervosa?

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Bulimia nervosa (BN) is an eating disorder that can lead to many medical complications, including hair loss. Hair loss can be a response to many different illnesses and life changes, and just because someone is experiencing hair loss does not mean they are living with BN. However, hair loss can indicate bulimia nervosa in conjunction with other signs and symptoms such as an obsessive focus on body weight, binge eating, and purging or compensating after eating.

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Does bulimia nervosa cause hair loss?

Bulimia nervosa affects the body’s integumentary system, including skin, nails, and hair. (1) Frequent purging episodes associated with BN can cause dehydration. When the body doesn’t have enough water, it can result in hair changes, including hair loss. Dehydration can affect other parts of the integumentary system, and may result in dry skin and brittle nails. 

Why does bulimia nervosa cause hair loss?

Human hair goes through a growth and shedding cycle, which includes three stages: (2)

  1. Anagen: the active stage of hair where new hair forms and grows.
  2. Catagen: the transitional phase where growth stops.
  3. Telogen: the resting stage when hair sheds. 

When a person is experiencing BN, the anagen stage stops prematurely either because the body is not getting enough food and water, vital organs are not optimally performing, or the person is experiencing gastric abnormalities. (3) Without new hair development, existing hair will eventually shed, leading to hair loss.

Some people will not experience hair loss while actively engaged in an eating disorder such as BN, but will notice that hair loss occurs after they have begun recovery. This can occur because new hair was not growing and hair shedding was not triggered while eating disorder behaviors were occurring. Once the body is better nourished and new hairs begin to grow, this will trigger the shedding of many hairs which were not previously shed. 

Hair also depends on the protein keratin to grow. Keratin is also important in forming nails, skin, and the lining of organs and glands. (4) In some cases of BN, if the body doesn’t have enough keratin, it will prioritize what part of the body needs the protein the most. It’ll often go toward lining organs instead of growing hair.

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How to stop hair loss from bulimia nervosa

One of the first steps to stopping bulimia nervosa related hair loss is to treat the underlying eating disorder. Nutrients and water help promote hair growth, so it’s vital for someone with BN to first work on their relationship with food and eating. Hair growth can return once an individual is receiving consistent and adequate nutrition. 

There is anecdotal evidence that applying castor and coconut oils to the hair as an at-home treatment will improve hair strength and growth, but there is currently no clinical evidence to support those claims. The best option for treating hair loss is to speak with a medical professional about medically-approved treatments such as prescription medications or therapies. (5) Individuals can also contact a hair restoration specialist in their area for custom hair care treatments and guidance for bulimia nervosa-related hair loss.

It takes courage to seek help for an eating disorder, and the experts at Within Health are available to help. Within offers personalized treatment programs designed to help individuals adapt to their specific life circumstances at home. Clients receive care to help cope with challenges around food and the body while also exploring interpersonal concerns, including the emotional side of hair loss.

Every person who works with Within receives empathy, authenticity, and humanity, no matter their size, shape, sexuality, gender expression, ethnicity, or background. Contact the admissions team today to start your healing journey.

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. Pietrangelo, A. (2019, March 15). The effects of bulimia on your body. Healthline. Retrieved February 15, 2022, from https://www.healthline.com/health/bulimia/effects-on-body#Integumentary-system
  2. WebMD. (2010, March 1). Science of hair: Hair growth cycle & how hair works. WebMD. Retrieved February 15, 2022, from https://www.webmd.com/skin-problems-and-treatments/hair-loss/science-hair
  3. Stevens, B. J. (n.d.). Bulimia nervosa and hair loss. The Trichological Society. Retrieved February 15, 2022, from https://www.hairscientists.org/hair-and-scalp-conditions/bullimia-and-hair-loss
  4. NCI Dictionary of Cancer terms. National Cancer Institute. (n.d.). Retrieved February 15, 2022, from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/keratin
  5. Mayo Foundation for Medical Education and Research. (2020, May 22). Hair loss. Mayo Clinic. Retrieved February 15, 2022, from https://www.mayoclinic.org/diseases-conditions/hair-loss/diagnosis-treatment/drc-20372932

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