Text Link

Learn more about the results we get at Within

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

Learn more about the results we get at Within

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

What are the complications of bulimia?

Bulimia nervosa (BN) is a serious eating disorder that can have a large impact on both mental and physical health. The disorder’s frequent purging can take a toll on the body, while the unhelpful thoughts behind the behavior can contribute to stress, anxiety, and depression.

If you or someone you love is struggling with BN, it may be helpful to learn about the different health risks of bulimia, to understand all the medical complications at play, and hopefully guide yourself or your loved one to the appropriate treatment that can lead to healing.

 minute read
Last updated on 
November 14, 2023
January 17, 2024
Complications of bulimia
In this article

Physical bulimia nervosa health risks

Bulimia may be considered a mental health condition, but the disorder can lead to quite a number of physical difficulties.

A majority of physical bulimia complications are directly tied to the disorder’s purging behavior.1 While self-induced vomiting is the most commonly used method, there are a number of other ways a person struggling with bulimia may experience purging, including through excessive use of laxatives, excessive exercise, or periods of severe food restriction.

The specific bulimia nervosa symptoms a person may encounter can depend on the purging methods being used. But, generally, bulimia consequences impact nearly every system of the body.

Digestive system

Many health risks of bulimia are related to the digestive system, due to the cycles of binge eating and purging that characterize BN. These cycles can bring on a range of short- and long-term effects, including:2

  • Stomach irritation, heartburn, or gastroesophageal reflux disease (GERD)
  • Irritated, torn, or ruptured esophagus
  • Chronic sore throat
  • Difficulty swallowing or pain when swallowing

Aside from the digestive system itself, many types of purging can also impact oral health, causing bulimia symptoms such as:2

  • Puffy cheeks (also called “bulimia cheeks”), a result of inflamed glands in the face
  • Sores in the mouth, tooth sensitivity, or tooth decay

Those who purge through the use of laxatives could also see bulimia complications arise in their bowel movements. Bloating, diarrhea, or chronic constipation could become an issue for someone whose body begins relying too heavily on laxatives to stimulate release. Hemorrhoids are another common problem.2,3

Endocrine system

Bulimia can also wreak havoc on the endocrine system, which is responsible for the regulation of hormones. As hormones play a key role in nearly every bodily function, these bulimia nervosa health risks can have a detrimental domino effect within the body, resulting in:4

  • Low sex drive
  • Fertility issues
  • Potential pregnancy complications, including higher risk for:
    - High blood pressure
    - Gestational diabetes
    - Miscarriage
  • Amenorrhea (loss of menstruation)

Aside from contributing to these physical difficulties, imbalanced hormones can also play a role in mental health complications of bulimia, by contributing to mood disorders that may exacerbate or prolong a person’s struggle with BN.5

Circulatory system

Hormones aren’t the only aspect of the body that can fall out of balance when someone is struggling with bulimia. Electrolytes—or the electrically-charged essential minerals in the blood and other bodily fluids—can also diminish over time as someone continues participating in purging behavior.

This can lead to a number of bulimia risks, including muscle weakness, extreme fatigue, and dizziness.

Electrolytes are also essential in the upkeep of heart health. An imbalance can play a part in difficulties such as:2

  • Low blood pressure or a weak pulse
  • Anemia
  • Heart failure in severe cases

And those who purge through self-induced vomiting also run a risk of rupturing small blood vessels, especially those in the eyes.2

Integumentary system

Most people don’t think of skin as an organ, but it is, in fact, the body’s largest organ. Indeed, the covering comprises an entire organ system, called the integumentary system.

Made up of the skin, hair, and nails, this system, too, is not immune to the health risks of bulimia. The biggest bulimia complication to the integumentary system is typically dehydration brought on by the excessive output of purging.

Without proper levels of water and electrolytes, the skin, hair, and nails can turn brittle, flaky, or scaly. People with bulimia may also experience premature hair loss or thinning.2

Those who purge through self-induced vomiting may also see calluses or sores on their fingers or the backs of their hands, due to that area’s frequent contact with stomach acid, or possibly from accidental biting down on the hand while purging.

bulimia health risks digestive system list graphic

Emotional/psychological bulimia consequences

Bulimia nervosa is also closely tied to a person’s mental and emotional state, causing another set of bulimia nervosa complications for the person struggling with the illness.

Some of those mental and emotional health risks can be caused by the uneven diet and lack of many nutrients, vitamins, and other essential compounds that result from restricting and purging.

Hormonal imbalance, for example, can directly lead to or worsen mood disorders, such as anxiety and depression, which, in turn, often play a big role in sustaining bulimia.5 It’s also possible for these conditions to have existed before someone developed the disorder, or for a person to have a higher risk factor for developing depression or anxiety disorders generally.

Once someone is entrenched in the behavioral patterns of bulimia, other emotional and psychological bulimia health consequences may come to the surface, including:6,7

  • Obsessive-compulsive behaviors, such as compulsive exercising
  • Obsessive rituals, especially around eating and meals
  • Low self-esteem, self-isolation, and acts of self-harm
  • Intense fear of gaining weight
  • Feeling a loss of control when eating

As with the effects of most eating disorders, many of the psychological complications of bulimia can either cause the disorder, be caused by the disorder, or both.

When to seek treatment for bulimia

Encouragingly, it’s entirely possible to make a full recovery from bulimia nervosa and continue along the road to better health and healing.

When asking when to seek treatment for bulimia nervosa or other eating disorders, the answer is almost always as soon as possible. The disorder can have detrimental long- and short-term effects on mental and physical health, which tend to get worse the longer it goes on. And people struggling with BN have, unfortunately, been found to have a higher risk of both suicidal ideation and suicide attempts.8

If you are asking yourself whether you or a loved one should seek out eating disorder treatment, it’s likely time to start. Luckily, there are a number of therapies, treatments, and other services that can help make a positive difference, eliminate the health risks of bulimia, and help get you or your loved one on the way toward a full recovery.

Within Health offers virtual care programs attuned to your specific needs. Call us today to learn more about getting started.
Get help >

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.


  1. Forney, K. J., Buchman-Schmitt, J. M., Keel, P. K., & Frank, G. K. (2016). The medical complications associated with purging. The International Journal of Eating Disorders, 49(3), 249–259.
  2. Mehler, P. S., & Rylander, M. (2015). Bulimia nervosa – medical complications. Journal of Eating Disorders, 3(1).  
  3. Roerig, J. L., Steffen, K. J., Mitchell, J. E., & Zunker, C. (2010). Laxative abuse: epidemiology, diagnosis and management. Drugs, 70(12), 1487–1503.
  4. Jones, W., Morgan, J. F. (2018). Reproductive and sexual health needs of women with eating disorders. Advances in Psychiatric Treatment, 16(6), 476.
  5. Barchas, J., Altemus, M. (1999). Endocrine, Circadian and Behavioral Processes in Mood Disorders. Basic Neurochemistry: Molecular, Cellular and Medical Aspects. Lippencott-Raven.
  6. Bulimia nervosa. Cleveland Clinic. Accessed November 2023. 
  7. Pollack, L. O., & Forbush, K. T. (2013). Why do eating disorders and obsessive-compulsive disorder co-occur? Eating behaviors, 14(2), 211–215.
  8. Smith, A. R., Zuromski, K. L., & Dodd, D. R. (2018). Eating disorders and suicidality: What we know, what we don’t know, and suggestions for future research. Current Opinion in Psychology, 22, 63–67.


Further reading

Dangers of bulimia nervosa on your health and well-being

Bulimia nervosa is an eating disorder characterized by extremes. People struggling with this condition move...

Recognizing bulimia nervosa symptoms in teenagers

Bulimia nervosa (BN) is a dangerous eating disorder that affects people of all ages, but the condition can...

How to be a supportive partner when dating someone with bulimia nervosa

A strong support system is one of the most important tools a person can have when recovering from an eating...

Can your heart recover from bulimia?

Bulimia nervosa (BN) is an eating disorder characterized by a cycle of restricting food, binging, and...

Treating bulimia and anemia

Bulimia and anemia tend to coexist. Bulimia nervosa (BN) is a type of eating disorder involving restricting...

Can bulimia cause high cholesterol?

Bulimia nervosa (BN) causes many short-term physical effects. However, long-ranging health concerns are...

Bulimia facts and statistics

Bulimia nervosa (BN) is an eating disorder characterized by a recurrent cycle of binging and purging...

Bulimia’s impact on your sleep

Bulimia nervosa (BN) can have a significant impact on numerous aspects of...

Does bulimia cause hearing loss?

Most people are familiar with the digestive system complications bulimia...

Why does bulimia cause broken blood vessels?

Attempts at vomiting put extra pressure on the blood vessels of the...

What is bulimia bloat?

Bulimia bloat is not a medical term, but it is frequently used to describe the distended (swollen) belly...

Which digestive problems does bulimia cause?

Bulimia nervosa (BN) is a serious mental health disorder, but the condition often manifests as a number of...

Why does bulimia shaking occur?

Bulimia nervosa (BN) is a serious mental health condition, but it manifests in a number of physical ways...

Can bulimia cause ulcers in the stomach?

The connection between bulimia and stomach ulcers is due to stomach...

Bulimia nervosa and thyroid issues

Bulimia nervosa (BN) is an eating disorder characterized by cycles of binging and purging, or periods of...

What is sialadentis, or bulimia cheeks?

Bulimia nervosa (BN) is one of the most widely-recognized eating disorders impacting...

How bulimia can (permanently) affect your teeth

Bulimia nervosa (BN) is a serious psychiatric disorder that involves frequent...

What are the complications of bulimia?

Bulimia nervosa (BN) is a serious eating disorder that can have a large impact on both mental and physical...

What are bulimia teeth?

Bulimia nervosa (BN) is a serious mental health disorder involving cycles of binge eating and purging...

The relationship between bulimia, skin, and acne

Bulimia nervosa (BN) is a mental health disorder, but the condition can also cause a number of physical...

Is there a relationship between bulimia, acid reflux, and GERD?

Acid reflux and gastroesophageal reflux disease (GERD) are medical conditions involving the movement of...

Is hair loss a symptom of bulimia nervosa?

Bulimia nervosa (BN) is an eating disorder that can lead to many medical comp...

How bulimia affects the jaw: pain and swelling problems

Bulimia nervosa (BN) is an eating disorder that affects many parts of the body, incl...

How bulimia affects your period

Eating disorders like anorexia nervosa (AN), binge eating disorder (BED), and bulimia nervosa (BN) may...

How bulimia affects the upper GI and respiratory tract

Bulimia nervosa (BN) is an eating disorder that involves frequent purging...

How bulimia affects your knuckles

Bulimia nervosa (BN) is a serious eating disorder, in which people engage in eating...

Blood in vomit from bulimia: esophagus damage caused by throwing up

Bulimia nervosa (BN) is a serious eating disorder that can have numerous medical complications if left...

Can bulimia cause cancer?

Some diseases are more likely to lead to cancer than others. For example, alcoholism...

Russell's sign: bulimia knuckles, hands and fingers

Although bulimia nervosa (BN) is an insidious disease, usually characterized by secretive behavior to mask...

Can bulimia cause headaches?

It’s common for individuals with bulimia nervosa (BN) to experience headaches. One...

Bulimia and pregnancy complications and birth defects

Pregnancy can be an exciting time for a mother-to-be. Many expectant mothers look...

Further reading

No items found.