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Last updated on August 28th, 2025 at 06:39 pm
Bulimia nervosa is a serious eating disorder that doesn’t just affect physical appearance—it can have profound and potentially life-threatening effects on your heart. If you’re struggling with bulimia, it’s important to understand how this eating disorder can impact your blood pressure, heart rate, and electrolytes.
Frequent bingeing and purging don’t just affect your body weight, they can cause serious heart problems by throwing off your body’s balance of electrolytes like potassium and sodium. This imbalance can lead to dangerous heart rhythms, muscle weakness, and even life-threatening complications.
Knowing how bulimia affects your heart can empower you to recognize warning signs early and seek the right support. In this article, we’ll break down what bulimia does to your heart and how taking care of yourself during recovery can protect your cardiovascular health.
Bulimia and The Heart
Bulimia can have both short and long-term impacts on your heart. From irregular heart beat to heart attacks, symptoms of bulimia and the heart can be life threatening.
Some of the changes to the heart that occur with bulimia nervosa are reversible with supervised weight restoration.
Short Term Impacts of Bulimia on The Heart
Bulimia can cause immediate effects on your heart that require attention. Frequent purging leads to electrolyte imbalances, especially low potassium (hypokalemia)—which can cause irregular heartbeats (arrhythmias) and palpitations.
Some of the earliest symptoms of bulimia on the heart include Hypotension (low blood pressure) or Bradycardia (slow heart rate).
You might experience a rapid or pounding heartbeat, dizziness, or chest pain. Dehydration from vomiting or laxative use puts extra strain on your cardiovascular system, leading to low blood pressure and fainting spells. These short-term heart complications can be warning signs of more serious damage if bulimia continues untreated.
Long Term Impacts of Bulimia on The Heart
If bulimia continues untreated, the ongoing strain on the heart can lead to chronic complications like cardiomyopathy (weakened heart muscle), heart failure, and increased risk of sudden cardiac arrest.
You might experience reduced left ventricular mass and increased risk of cardiac arrest from QTc Interval prolongation if bulimia and starvation syndrome continue to go left untreated.
Persistent electrolyte disturbances damage the heart’s electrical system, leading to dangerous arrhythmias that can be fatal. Additionally, malnutrition from bulimia may cause structural changes to the heart, reducing its efficiency and increasing fatigue and shortness of breath..
Bulimia Chest Pain
Chest pain in bulimia can happen for several reasons, and it’s often linked to the way the disorder impacts the heart, esophagus, and muscles involved in breathing.
Here are the main causes of bulimia chest pain:
1. Heart strain from electrolyte imbalances
- Repeated vomiting, laxative use, or diuretic abuse can cause low potassium, magnesium, and sodium.
- These electrolytes help regulate your heartbeat. When they’re out of balance, the heart muscle can spasm, beat irregularly, or weaken, all of which can feel like chest pain.
- Severe imbalances can trigger arrhythmias or even a heart attack.
2. Esophageal irritation and spasm from purging
- Stomach acid from vomiting irritates and inflames the esophagus.
- This can cause esophagitis (inflammation) or esophageal spasm, both of which produce sharp or burning chest pain that can mimic heart pain.
3. Acid reflux (GERD)
- The repeated pressure from vomiting and weakened esophageal sphincter can lead to chronic acid reflux.
- Acid reflux pain often feels like a burning behind the breastbone, especially after eating or lying down.
4. Muscle strain in the chest wall
- Forceful vomiting can strain the intercostal muscles (between the ribs) or the diaphragm.
- This pain is usually more localized and worsens when you move or breathe deeply.
5. Anxiety and panic attacks
- Bulimia is often accompanied by high anxiety, and panic attacks can cause intense chest tightness, rapid heartbeat, and shortness of breath.
- While panic-related pain isn’t from physical heart damage, it still needs medical attention to rule out heart problems.
Bulimia Heart Attack Risks
While exact numbers on heart attacks specifically caused by bulimia nervosa are limited, cardiovascular complications are a leading cause of medical emergencies and mortality among individuals with bulimia.
The disorder’s cycles of bingeing and purging, and/or laxative abuse cause severe electrolyte imbalances and dehydration, which can trigger dangerous arrhythmias that increase the risk of sudden cardiac arrest, a sudden, often fatal, heart event closely related to heart attacks.
Risk Factors Include:
- Electrolyte imbalances: Low potassium, magnesium, and sodium from frequent vomiting or laxative abuse disrupt heart rhythms.
- Dehydration: Reduces blood volume and strains the heart.
- Arrhythmias: Irregular heartbeats caused by electrolyte disturbances can lead to sudden cardiac arrest.
- Malnutrition: Weakens heart muscle and overall cardiovascular function.
- Use of stimulants: Some individuals with bulimia misuse substances like caffeine or diet pills, which increase heart rate and blood pressure.
- Underlying mental health conditions: Stress and anxiety can exacerbate heart risks.
- Changes in the heart structure:
Because bulimia can silently damage your cardiovascular system over time, even in young people, regular medical monitoring and early treatment are vital to reduce the risk of heart attacks and other serious cardiac events.
Treating Heart Irregularities in Bulimia
In order to treat chest pain and heart irregularities in bulimia, you must treat the underlying eating disorder. Bulimia recovery can be a long and difficult process that will require a treatment team trained in eating disorders.
Treating bulimia will require:
- A recovery meal plan specific to your needs or using the plate by plate approach
- Stopping any compulsive exercise
- Meal support
- Challenging fear foods
- Medical management for edema and electrolyte shifts
- Managing clinical symptoms
Eating disorder recovery can be a long and difficult journey full of many ups and downs. Tune into some of these eating disorder songs or recovery bible quotes to help keep you strong. You can also check out my eating disorder recovery story.
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