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Bulimia Nervosa - What Happens

When you have bulimia, you judge yourself harshly on your body weight and shape. In order to help cope with these feelings, you follow a strict diet to try to lose weight. But over time, the hunger from your diet triggers you to binge eat. Binge eating may also be triggered by a stressful event, when food gives you a sense of comfort. Feeling guilty and ashamed of binge eating can cause you to purge to avoid weight gain. This starts the cycle of binging and purging that becomes a habit.

As bulimia develops, you may not eat at the beginning of the day. But later you may binge to comfort yourself, especially at the end of a stressful day.

Vomiting causes the body to release endorphins, which are natural chemicals that make you feel good. Eventually you may make yourself vomit even if you have not overeaten so that you can feel good. Soon you lose control over the binge-purge cycle. Repeated vomiting, fasting, exercising too much, or misusing laxatives, diuretics, ipecac syrup, or enemas will eventually cause serious, long-term health problems.

After bulimia becomes a pattern, it is very hard to return to normal eating without help. Unhealthy eating behaviors can continue for many years before a person seeks treatment.

If not treated, bulimia can lead to serious, long-term health problems. It is common for people to hide the condition from others for years. By the time others discover the disorder, many people with bulimia already have serious problems. These range from mild to severe, depending on the type of purging behaviors and how long they have continued. Health problems caused by bulimia include:

  • Tooth decay, toothaches, swollen gums, gum disease (gingivitis), and erosion of tooth enamel. These are caused by acid in the mouth from vomiting.
  • Osteoporosis.
  • Electrolyte imbalances and changes in metabolism that can lead to heart problems, such as arrhythmia and even death.
  • Dehydration, which can lead to weakness, fainting, or kidney damage.
  • Inflammation or tears of the esophagus, which may cause bloody vomit.
  • Swollen salivary glands.
  • Fainting or loss of consciousness, usually because of low blood pressure.
  • Low body temperature.
  • Suicide risk when feeling discouraged about having bulimia or a relapse or about ongoing body image issues.
  • Long-term problems with bowel movements because of laxative abuse.
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