Bulimia nervosa, commonly known as bulimia, is an eating disorder characterized by binge eating followed by purging. Purging can involve vomiting, fasting, excessive exercise, or using laxatives, diuretics, or enemas.

Bulimia is a serious mental health condition that can have long-term effects on physical and emotional wellbeing. According to the National Eating Disorders Association (NEDA), around 1.5% of American women and 0.5% of American men will develop bulimia in their lifetime.

1. Bad breath and decayed teeth

Acid from repeated vomiting can erode tooth enamel, leading to tooth decay, sensitivity, and discoloration. A person with bulimia may also have bad breath due to the stomach acids that come up during vomiting.

They may try to mask the odor with mints, gum, or mouthwash.

2. Calluses on the knuckles

Repeatedly sticking fingers down the throat to induce vomiting can cause calluses, bruises, or scars on the knuckles and back of the hand.

A person with bulimia may wear long-sleeved tops to hide these signs or avoid activities that could expose their hands.

3. Irregular menstrual cycles

Bulimia can cause hormonal imbalances that disrupt the menstrual cycle. A person with bulimia may experience irregular periods, missed periods, or changes in the length, flow, or intensity of their period.

Menstrual irregularities can increase the risk of reproductive health problems, such as infertility or polycystic ovary syndrome (PCOS).

4. Swollen salivary glands

Constant vomiting can irritate and inflame the salivary glands, causing them to swell and make it hard to swallow or speak. Swollen salivary glands can also create a noticeable bump on the lower jaw or under the tongue.

5. Sore throat and hoarseness

Acid reflux from frequent purging can damage the lining of the throat, causing pain, irritation, and a scratchy or raspy voice. A person with bulimia may experience a sore throat, a chronic cough, or difficulty swallowing.

6. Electrolyte imbalances

Electrolytes are minerals in the body that regulate fluid balance, nerve function, muscle contraction, and energy production.

Vomiting, laxative abuse, or excessive sweating can lead to electrolyte imbalances, such as low potassium, low sodium, or low magnesium. Electrolyte imbalances can cause fatigue, weakness, dizziness, heart palpitations, or seizures, and may require medical attention.

7. Digestive problems

Bulimia can cause digestive issues such as bloating, constipation, diarrhea, or stomach cramps.

Over time, purging can damage the digestive system and lead to more severe problems, such as inflammation of the esophagus, stomach ulcers, or intestinal obstruction.

8. Low self-esteem and perfectionism

Bulimia is often associated with low self-esteem, anxiety, depression, or trauma. A person with bulimia may feel ashamed, guilty, or powerless about their eating habits, body image, or personal life.

They may also be preoccupied with achieving unrealistic standards of perfection in their appearance, job performance, or relationships.

Due to feelings of shame, embarrassment, or fear of judgment, a person with bulimia may avoid social events, hobbies, or opportunities that involve food or body exposure.

They may also hide or lie about their eating habits or engage in rituals or patterns of behavior that interfere with daily life. Social isolation and secrecy can worsen the sense of loneliness, anxiety, or depression and make it harder to seek help.

10. Alcohol or drug abuse

Studies have shown that people with bulimia may have a higher risk of developing alcohol or drug abuse disorders. Alcohol and drugs can serve as a coping mechanism or a way to escape from emotional pain or stress related to bulimia.

However, substance abuse can also have negative effects on physical and mental health and increase the risk of accidents or addiction.