Eating Disorders - Complications of Bulimia

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In all cases, patients who have both bulimia and anorexia are in greatest danger of health risks.

Long-Term Psychiatric Problems

In the 2002 study mentioned above, eating disorders, even with normal weight, were associated with a higher risk for anxiety and depressive disorders and with suicide attempts.

Self-Destructive Behavior

A number of self-destructive behaviors occur with bulimia:

• Smoking. Many teenage girls with eating disorders smoke because it is thought to help prevent weight gain.
• Impulsive Behaviors. Women with bulimia are at higher-than-average risk for dangerous impulsive behaviors, such as sexual promiscuity, self-cutting, and kleptomania. Some studies have reported such behaviors in half of those with bulimia.
• Alcohol and Substance Abuse. An estimated 30 - 70% of patients with bulimia abuse alcohol, drugs, or both. This rate is higher than that of the general population and for people with anorexia. However, this higher rate of substance abuse may be a distortion because studies are conducted only on diagnosed patients. Bulimia tends not to get diagnosed. And reports of bulimia in the community (where the incidence of the eating disorder is higher than statistics suggest) indicate that substance abuse is actually lower than in people with anorexia.

Abuse of Over-the-Counter Medications

Women with bulimia frequently abuse over-the-counter medications, such as laxatives, appetite suppressants, diuretics, and drugs that induce vomiting (ipecac). None of these drugs is without risk. For example, ipecac poisonings have been reported, and some people become dependent on laxatives for normal bowel functioning. Diet pills, even herbal and over-the-counter medications, can be hazardous, particularly if they are abused.

Review Date: 12/13/2006
Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital.