Eating disorders are complex mental health conditions characterized by various abnormal and harmful eating patterns. The effects of an eating disorder do not stop at weight loss or gain. They can have significant and debilitating mental, physical, and psychological health. Over ten thousand Americans lose their lives to complications related to an eating disorder yearly. Additionally, up to five percent of those who suffer from eating disorder symptoms will attempt suicide. 

There is no single “cause” of eating disorders. Researchers believe a combination of social, cultural, genetic, and environmental factors increases the risk of developing an eating disorder. Like drugs for someone with a drug use disorder, someone with an eating disorder manipulates food intake to cope with stress and achieve a sense of control over their environment. 

What is Bulimia Nervosa?

Anorexia nervosa is characterized by severely restricted food and calorie intake. Bulimia nervosa (bulimia), on the other hand, is characterized by instances of binging and purging behaviors. Someone with bulimia will binge  (overeat) on food and then forcibly purge (get rid of) the food from their body. Purging is often accomplished by self-induced vomiting or laxative use. Other symptoms common to bulimia nervosa include weight changes, anxiety, hunger, dental hygiene problems, food aversions, and bad breath. Studies suggest bulimia affects up to 3% of women and less than 1% of men. Data also shows it is nine times more likely to occur in women than men. Bulimia has a mortality rate of approximately 4%.

While bulimia nervosa may not be as common or well-known as other eating disorders, it is a severe and potentially life-threatening condition. Unlike anorexia, bulimia nervosa involves actively eating rather than intentionally restricting food or calorie intake. The Diagnostic and Statistical Manual of Mental Disorders (DSM) provides several diagnostic criteria for bulimia nervosa that set the illness apart from anorexia nervosa and other eating disorders. 

For medical or mental health providers to diagnose bulimia nervosa, one must meet several specific conditions. First, you must “experience recurrent episodes of binge eating followed by behavior to “compensate” for binge eating.” These compensatory behaviors may include laxative or diuretic abuse, misuse of weight loss medications, or self-induced vomiting. The DSM defines binge eating as “consuming an abnormally large period of food in a specific period” (usually 2 hours). 

This amount of food consumed is significantly larger than most people would eat in the same period under similar circumstances. Additionally, during this period, there is a distinct lack of control over eating. In addition to binging and compensating, you must engage in both “binging and compensating at least once per week for at least three months.” 

What are the two ways people with bulimia restrict calories?

There are two ways someone who has bulimia restricts calories.

Purging type

Someone with the purging type of bulimia engages in self-indued ways to “purge” food from their system. This may involve forced vomiting or misuse of diuretics, enemas, laxatives, or other drugs that clear the intestines of food. 

Nonpurging type

Someone with nonpurging bulimia uses other behaviors and methods like excessive exercise and fasting to cleanse the system of calories rather than using other purging behaviors. 

What are the Physical Effects of Bulimia?

Someone with bulimia engages in several habits or behaviors that can be incredibly painful and harmful to several body systems. Unfortunately, the physical side effects of bulimia, depending on their severity, can be difficult (sometimes impossible) to treat. Below are several physical effects typically associated with bulimia nervosa.

Tooth Decay

A common characteristic of bulimia nervosa is induced vomiting. The stomach contents are very acidic, and to leave the body, these contents must pass over the teeth. Repeated vomiting over time leads to the breakdown of the tooth enamel. This can sometimes lead to costly dental procedures, tooth decay, and tooth loss.

Sialadenitis (swollen salivary glands)

One “visible” physical side effect of bulimia is swollen salivary glands. When someone with bulimia nervosa has been vomiting daily for a long time and suddenly stops (as they would when entering treatment), the parotid salivary glands in front of the ears at the base of the jaw may swell. This leads to the appearance of puffy or swollen cheeks. Although frustrating and worrisome to patients in treatment, this condition generally resolves in a few weeks as long as vomiting does not occur again. 

Russell’s Sign

Russell’s Sign is another visible sign of self-induced vomiting. It is also a tell-tale indication someone may be suffering from bulimia symptoms. Russell’s Sign is the term for the scratches on the back of one’s hand that occur from hitting the teeth when inserting their finger into the throat to induce a gag reflex. 

Dehydration

All types of purging behaviors typical to bulimia are likely to lead to dehydration. A notable portion of the weight lost with purging activities is actually water loss from various areas in the body. If dehydration becomes severe, you are at an increased risk of confusion, dizziness, falling, loss of consciousness, and potentially permanent kidney damage.

Sore throat and hoarse voice

The acid in stomach contents is not only damaging to the teeth and your esophagus but to your throat and vocal cords as well. It is not uncommon for someone with bulimia to have a sore throat and experience chronic hoarseness with repeated vomiting. 

Acid reflux

When vomiting occurs, the lower esophageal sphincter (the “doorway” between your stomach and your esophagus) is forced to open. If it does not open, the stomach contents cannot move back through the esophagus. In time, with repeated vomiting, the sphincter, a muscle, grows weak, allowing stomach acid to repeatedly enter the lower esophagus. 

This particular physical side effect of bulimia can cause painful and uncomfortable burning or pain in the chest. Chronic, untreated acid reflux can also cause significant damage to the esophagus’s lining, leading to bleeding and scarring.  

Intestinal problems

Another physical side effect of bulimia is problems in the digestive system and intestines. Using laxatives as a way to purge food can, for some, lead to a physical dependence on the actions of a laxative to achieve “normal” bowel movements. As a result, without laxative use, chronic constipation can develop. Although constipation will resolve in time and with adequate dietary change, it can be very uncomfortable for patients to stop abusing laxatives in the early days of eating disorder recovery. 

Electrolyte Imbalances

Electrolytes are crucial minerals that are essential to many critical body functions. Examples of electrolytes include calcium, potassium, and sodium. When electrolyte levels change dramatically, it can make it difficult for systems in your body to perform as needed. Purging behaviors of bulimia nervosa dramatically affect the body’s ability to keep these vital minerals in balance. The side effects of low electrolyte levels include potentially life-threatening medical emergencies, including cardiac arrest and death. 

In addition to the above, other effects of bulimia nervosa include a range of physical and emotional challenges. These include: 

• Mood swings
• Bloodshot (red) eyes
• Throat swelling
• Hemorrhoids
• Reduced sex drive
• Dry skin
• Pregnancy complications
• Anemia
• Ulcers
• Irregular periods
• Kidney failure

Eating Disorder Recovery

Unfortunately, the statistics on eating disorders and recovery are quite sobering, especially when you consider the sheer number of people who suffer from an eating disorder and choose not to or are unable to get help. With treatment and proper diagnosis, sixty percent of people with an eating disorder will make a full recovery. Only one in ten people suffering from an eating disorder will seek treatment. Treatment for eating disorders is the most effective when intervention occurs early; before, many of the physical side effects associated with the eating disorder have begun to have an adverse impact on the individual’s health. 

Successfully treating eating disorders requires comprehensive, specialized treatment. For some who seek help to overcome an eating disorder, medical intervention may be the first step on their recovery journey. Medical care may be necessary to stabilize and treat significant physical challenges that can develop from a period of unhealthy in inadequate eating behaviors. Once you are medically stable, you can transition to the therapeutic portion of an eating disorder treatment program

 at The Meadowglade. 

Treatment at a specialized eating disorder treatment program aims to address eating disorder symptoms successfully. For eating disorder therapy to be the most successful, it must be individualized, comprehensive, and multifaceted. This means your treatment program must include medical treatment, counseling

Mental health care, nutritional education, and relapse prevention education. 

Inpatient programs that include evidence-based therapy models are often the most effective way to heal and overcome eating disorder symptoms. They are also the best way to take active steps towards healing and achieving overall wellness. The road to recovery from an eating disorder can be long and complex, but with treatment and support, you can achieve recovery while healing your physical, psychological, and spiritual wellness. 

It is crucial to remember that an eating disorder will not just “go away” or disappear without treatment. While there may be times when your symptoms are less invasive or intrusive, the illness remains and can reoccur at any time. Even after completing an eating disorder treatment program, the risk of symptom relapse remains. Therefore, you must continue attending scheduled therapy appointments and support groups and following your relapse prevention program. 

Although eating disorders cannot be “cured,” you can achieve recovery and learn how to manage symptoms of the illness. With specialized treatment at The Meadowglade, you can put the physical and emotional challenges associated with an eating disorder in the past. To learn more about our eating disorder treatment program and how we can help you move to overcome your symptoms, contact us today. We understand the decision to seek help may be difficult. Let us help you take the first steps towards healing.

https://www.hopkinsmedicine.org/health/conditions-and-diseases/eating-disorders/bulimia-nervosa

https://www.healthline.com/health/bulimia-facts#10.-Its-a-lifelong-battle