Bulimia is an eating disorder that is characterized by recurrent binge-and-purge cycles. The periods of binging (consumption of an abnormally large amount of food in a short period of time) alternate with periods of purging (use of different unhealthy methods to get rid of eaten calories). This behavior can end up in serious complications. The consequences of bulimia can be classified as: in systemic consequences, digestive consequences, emotional and psychological consequences, etc.
The systemic consequences of bulimia, especially in the case of laxatives and diuretics overuse are different metabolic and electrolyte imbalances. Bulimia can cause amenorrhea (absence of at least three consecutive periods) and dehydration. The skin and mucous membranes become dry. Xerophthalmia (dry eyes) is frequently seen in bulimics. Some patients can develop metabolic alkalosis, arthralgia, zinc depletion, a low level of triptophan and serotonin, low level of serum calcium and chloride, and other complications.
Electrolyte imbalance, especially hypokaliemia, can lead to serious heart disorders, such as arrhythmias, shock and myocardial infarction. A serious consequence of bulimia in patients who purge by vomiting after binge episodes is dental erosion caused by the gastric acid. Dental erosion in bulimics has specific features and can be differentiated from dental caries and other teeth diseases. Recurring vomiting also leads to chronic sore throat with an unusual swelling of jaws and the formation of characteristic scars and calluses on the back of the hands and knuckles. Burning tongue can be present, too.
One of first signs of bulimia can be a benign, non-inflammatory enlargement of the parotid and other salivary glands (sialadenosis, parotidomegaly). Xerostomia (dry mouth) is common in patients with malnutrition and sometimes can be quite painful. Vitamin and mineral deficiencies can cause lanugo (soft downy hair on face, back and arms), edema (swelling of the tissues because of water accumulation), muscle atrophy and impaired neuromuscular function.
The most common digestive consequences of bulimia are tearing of the esophagus (because of vomiting), esophageal reflux, gastrointestinal bleeding, gastric rupture, constipation (laxative dependence), pancreatitis, and peptic ulcers. A severe consequence of acid reflux and vomiting is cancer of the larynx. Malnutrition and dehydration lead to hypotension (low blood pressure) characterized by dizziness, blurred vision, passing out, and headaches. Anemia is a frequent complication of iron and vitamin B12 (folic acid) deficiencies.
A depletion of calcium and bone protein leads to osteoporosis that may end up in pathological fractures. Emotional and psychological consequences of bulimia are the feeling of shame and guilt, depression, low self-esteem, difficult social relationships, and severe auto-aggression. The most dangerous and tragic consequence of bulimia is suicide caused by depression. Bulimia is a severe eating disorder that has serious complications and represents a great risk for the overall health and sometimes even for the life of the patient.