What Are The Medical Dangers?
Although bulimia rarely results in death, it can occur. Excessive vomiting leads to electrolyte imbalance. Electrolytes, which are chemicals in the body like potassium, chloride and sodium, help regulate heart beat. When they are depleted by purging or dehydration, heart arrhythmia—irregular heart beat—often takes place. Sometimes this is not serious and subsides when proper health and nutrition is restored, but for others it can lead to death from cardiac arrest. Kidney failure is another possible life-threatening side-effect of low potassium. Vomiting can be fatal due to choking or if the esophagus or bronchial passage is ruptured.
The most common medical problems for bulimics include rotten teeth, constipation, bloating and other digestive disorders, infected or swollen glands known as “chipmunk cheeks,” blisters in the throat, icy hands and feet, and fluid depletion. Other potentially serious, though generally rare, complications are abnormalities in the endocrine and gastrointestinal systems, anemia, internal bleeding, hypoglycemia, irregular menstrual periods or amenorrhea, osteoporosis, myopathy, and irregularities in brain imaging.
Some bulimics use syrup of ipecac, detergents, or foreign objects to induce vomiting—all of which are extremely dangerous. Ipecac, a horrible tasting liquid, is used to treat poison victims, and its abuse can produce muscle weakness or cardiac arrest (Mitchell, 1997; Mickley, 1999).
Laxative abuse can irritate intestinal nerve endings, which can inhibit them from triggering contractions. Heavy use of laxatives or enemas removes protective mucus from the intestinal lining, which can result in bowel infections. The lower bowel can lose muscle tone, becoming limp and unable to produce contractions. Dehydration and fluid imbalances can occur with the same sideeffects as listed above. Also, laxative abusers can have rectal pain, gas, constipation or diarrhea (or both), and bowel tumors.
Although not directly linked, individuals with eating disorders may tend to have other medical illnesses, including diabetes mellitus, cystic fibrosis, inflammatory bowel diseases such as Crohn’s disease, and thyroid disease. Diabetics with bulimia often misuse their insulin, which can be life-threatening (Bock, 1999; Zerbe, 1995).
It is difficult, if not impossible, to know which bulimics are at greatest risk for developing any of these specific conditions. Certainly, the longer someone has bulimia, the more likely they are to experience associated medical problems. However, even someone who has only started to purge faces the possibility of serious physical consequences, even death.
Many bulimics have concerns about getting or being pregnant. Some fear that their vomiting will harm the child or that they will get too fat. Although information on pregnancy and eating disorders is limited, what we do know is:
1. Although women with disordered eating are more likely to deliver babies that are small, major birth defects do not accompany bulimia or anorexia nervosa.
2. Since a mother who purges has a separate digestive system than her fetus, the child is generally not harmed. However, poor nutrition and negative frame of mind are unhealthy for mother and child.
3. For women in treatment, some antidepressants can be used but others should be avoided. In any case, they should check with their doctors about the specific medications that they are taking.
4. A large percentage of women experience remission of their bulimic symptoms while they are pregnant. They may feel that their bodies belong to their babies during pregnancy, and thus eliminate unhealthy behaviors. However during the postpartum period they are likely to return to their bulimia, especially faced with their added weight.
5. The birth of a child also brings up other emotional issues for bulimic women, which include mother/child relationships, how the eating disorder will affect parenting, sexuality and attractiveness, separation conflicts, and worries over proper feeding for baby. These should all be addressed for the welfare of the mother and child (Yager, 1997; Zerbe, 1995).
Reprinted with permission from Bulimia: A Guide to Recovery
By Lindsey Hall and Leigh Cohn
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