Binge Eating & Purging

Health Effects of Binge Eating and Purging

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Binge eating and purging and accompanying behaviors, such as dieting and excessive physical exercise, can be harmful to your health. Common complications of these behaviors can affect your heart, brain function, bones, teeth, and digestive system.

In general, severe dieting associated with low weight will also be associated with cardiovascular problems, menstrual problems, and osteoporosis (a disease characterized by low bone mass and the structural deterioration of bone tissue). Overweight, seen mostly with binge-eating disorder, is associated with all the problems of overweight and obesity, including diabetes, high cholesterol levels, and high blood pressure.

Dieting

Reducing the number of calories you consume also cuts your intake of necessary minerals, such as calcium, potassium, and magnesium, in addition to vitamins, although outright vitamin deficiency is rarely seen in bulimia nervosa or binge-eating disorder.

Fluid intake may also be reduced, leading to dehydration. As well, because bulimics tend to avoid what they perceive as fattening foods, they may cut protein and fat intake. Some of these deficiencies are corrected by the amount and type of food eaten during binges, creating a mixed picture, depending on the severity of dietary restriction and binge eating.

Nonetheless, low-weight individuals may experience low blood pressure and heart rate as a result of strict dieting, giving rise to feelings of weakness and dizziness, and sometimes fainting. These feelings may be aggravated by the dehydration that accompanies food restriction, which is of course worsened by purging methods such as vomiting, using laxatives and diuretics, and exercising excessively.

Calcium and protein deficiencies may lead to a reduction of bone density (osteopenia) and ultimately to osteoporosis. When osteopenia or osteoporosis is combined with excessive exercise, the risk of stress fractures is much increased. Occasionally, anemia (a reduction in red blood cells and/or hemoglobin) may occur as a complication of dieting.

Because of the caloric and fluid restriction associated with dieting, thinking may become difficult and disorganized. In simple terms, one is not ingesting enough energy to fuel the normal functioning of the brain. Difficulties in thinking may affect work performance and interpersonal relationships. In addition, many bulimics find themselves continually thinking about dieting and binge eating. Such obsessive thoughts act as a distraction and may also interfere with work and other activities.

Both skin and hair may also suffer. Dieting and the resultant lack of protein may lead to increasingly brittle hair and eventually, when combined with a drop in weight, to hair loss. Skin may also become drier and may be more susceptible to infection. Losing too much weight may also lead to irregular menstruation or to amenorrhea (the absence of menstruation), and excessive exercise may exacerbate these problems.

Purging

Because purging, particularly in the form of self-induced vomiting, results in a loss of calories and causes dehydration, it makes the deficiencies associated with dieting only that much worse. In addition, electrolytes such as potassium may be lost.

About 5% of purging bulimics have significantly lowered levels of potassium, one of the most dangerous complications of bulimia, and one that should be immediately corrected with potassium supplements taken under the direction of a physician who can frequently monitor potassium levels.

Potassium loss can be dangerous because it alters the action of the heart, causing arrhythmias (abnormal heart rhythms), which can occasionally lead to sudden death in low-weight bulimic individuals. Because of the force used to bring up food, self-induced vomiting can tear the esophagus, which may result in one’s spitting up blood.

One sign associated with purging, particularly self-induced vomiting, is swelling of the parotid glands, which are behind the ears and below the jaw. The swelling is often painful, similar to that experienced with mumps.

Dental problems are one of the most frequent complications of purging. Indeed, most individuals who have purged regularly for 4 or more years have dental complications. Acid in the mouth from self-induced vomiting leads to erosion of tooth enamel, sometimes to the point where fillings rise above the surface of the tooth that has been eroded away. Binge eating sweet foods probably makes this problem worse and contributes to tooth decay. It is not unusual for these problems to lead to gum disease and dental abscesses, with tooth loss and sometimes bone loss.

Bulimics often brush their teeth immediately after purging. This, however, causes further enamel erosion because the acid softens the enamel. After purging, it is better to rinse the mouth with a teaspoon of baking soda dissolved in water, an alkaline solution that neutralizes acid.

Over-Exercising

Excessive exercise may be associated with menstrual disturbances, including amenorrheaOpens in new window (loss of the menstrual cycle), that may become chronic. Such exercise is associated with lower estrogen levels that, in turn, may worsen osteoporosis.

Excessive exercise is also associated with a variety of sports injuries, including stress fractures, which are aggravated by dieting and osteoporosis. In addition, exercising vigorously in hot weather increases dehydration and may aggravate potassium loss, causing an irregular heartbeat and sometimes death. Clearly, one must use common sense when exercising, and all exercise should be done in moderation. One should feel relaxed after exercise, not tired or exhausted.

Laxatives and Diuretics

The use of large doses of over-the-counter stimulant laxatives can lead to constipation and dehydration and may cause potassium loss. In addition, laxatives may cause melanosis coli, a condition in which the lining of the large intestine turns dark brown or black. This is a harmless condition and will reverse when laxative use is discontinued.

The use of diuretics or water pills also causes dehydration and leads to potassium loss. Prolonged use can lead to kidney damage and occasionally to kidney failure, requiring dialysis.

Bulimia Nervosa and Diabetes

Medical research has found that type 1 diabetes, with onset typically occurring in childhood or adolescence, is more common in bulimics than in those who do not have the disorder. In type 1 diabetes, the body’s immune system destroys the cells in the pancreas that make insulin. It is sometimes called insulin-dependent diabetes because it requires treatment with insulin.

Unfortunately, some of the behaviors associated with bulimia can worsen the medical complications of diabetes. For example, binge eating and purging make controlling diabetes much more difficult. Some individuals with bulimia stop taking their insulin in order to lose weight, and this worsens the control of their diabetes.

Most medical research suggests that bulimics are more likely to have more long-term medical complications than are other patients with type 1 diabetes. The worst combination seems to be withholding insulin combined with binge eating and purging.

One study found that 70% of such individuals had some form of nerve damage; half had retinopathy, a condition in which eyesight gradually deteriorates and which may lead to blindness; and a quarter had kidney problems that can ultimately lead to kidney failure.

Other complications included high blood pressure and stroke. Given these extra complications, it is critically important for bulimics with diabetes to overcome their binge eating and purging.

Binge Eating

The most obvious consequences of binge eating is weight gain and potential obesity. In addition, binge eating may lead to feelings of bloating, abdominal pain, and nausea. Very rarely, complications such as gastric dilatation or even rupture of the stomach caused by ingesting large amounts of food may occur.

The combination of dieting, binge eating, and purging may also slow digestion, which can lead to abdominal pain, bloating, and nausea. As noted earlier, binge eating on sweet foods may aggravate the dental problems frequently seen in bulimia nervosa.

Overweight, Obesity, and Binge Eating

Although some individuals with bulimia nervosaOpens in new window may be overweight, binge-eating disorderOpens in new window is most likely to be associated with overweight and obesity. As the degree of overweight and obesity increases, so does the proportion of those with binge-eating disorder. As studies have indicated, it is now thought that binge-eating disorder and obesity are separate disorders with different causes, although they often run in the same families.

Clearly, binge eating will lead to, or aggravate, overweight and obesity. Although stopping binge eating does not lead to weight loss in the short run, studies have shown that, over a longer term, those who stop binge eating are likely to weigh 10 – 15 1bs less than those who do not stop.

Although this may seem like a lot of weight to lose, the health effects of losing even 10 1bs can be quite significant. One problem for the binge eater is that dieting to lose weight will aggravate binge eating. Ultimately, dieting will lead to weight gain rather than weight loss. This is why it may be better to first overcome binge eating and then to gradually develop healthy eating and exercise habits.

Developing a healthy lifestyle, of course, is very difficult to do in today’s world. In the United States, about 3,900 calories are produced by the food industry for every person in the country. This is almost double the coloric requirement for the average person. Moreover, it is the job of the food industry to sell all those calories.

On top of all this, it is increasingly difficult to exercise enough. There are too few sidewalks in most communities, not all communities are safe to walk around, and almost no one can walk to work anymore. This is why it is so difficult for overweight persons to lose weight. Essentially, one has to defend oneself against an environment that predisposes to overweight and obesity.

Some of the medical problems associated with overweight and obesity are listed here, and many individuals with binge-eating disorder and overweight or obesity have more than one of these conditions:

All these disorders are potentially treatable, but it is better to try to avoid them in the first place.

Stopping binge eating is a good first step in this process. Although the various medical complications associated with binge eating and purging should be taken seriously, the effects on individuals’ lives are even more pronounced and often more disabling than the physical complications.