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Short and Long Term Effects of Bulimia Nervosa

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Bulimia nervosa can lead to an array of physical changes in your body.  There are both short and long term effects of bulimia nervosa on the body which we will walk through in this article.

Some of the most common effects of bulimia include: 

  • Dental erosion
  • Dental Caries 
  • Xerostomia (dry mouth)
  • Weight loss
  • Decreased bone mineral density
  • Loss of period (in women) 
  • Electrolyte imbalance 
  • Upper GI tract bleeding
  • Swelling of Parotid glands (face swelling)
  • Barretts esophagus
  • GERD
  • Changes in microbiome 
  • Dehydration

Some of the effects of bulimia nervosa are short term, while others may have long term impacts on the body. 

The best methods of preventing or reducing the severity of long term impacts of bulimia nervosa is to work with a skilled healthcare tem including a medical doctor, physician, and haes dietitian

Potential impacts on the body from bulimia nervosa will also relate to the type of purging the person is engaging in (vomiting, diuretic use, or withholding insulin in the case of type 1 diabetes).

Let’s explore some of the common symptoms we see with bulimia nervosa and their impacts on overall health. 

What is “Bulimia Face?” 

Bulimia face is the swelling of the face as a result of self induced vomiting producing swollen salivary glands. 

Contributors to bulimia face include: 

  • Reduced salivary flow rate resulting from vomiting 
  • Swelling of the three salivary glands including the parotid gland which is the largest
  • The appearance of “chipmunk like” cheeks as the result of the swelling

The appearance of bulimia face is that of “chipmunk cheeks” or puffy cheeks. 

Is Bulimia Face Swelling Reversible? 

Yes.  Bulimia face swelling is temporary as long as the person completely discontinues intentional vomiting. 

Salivary glands begin to decrease in size about 8 weeks after someone completely stops vomiting. 

bulimia face infographic with woman with brown hair holding her cheek

Will Everyone With Bulimia Nervosa Experience Bulimia Face Swelling? 

No.  While up to 80% of those with bulimia nervosa will experience face swelling, many will not.  

Face swelling is only one symptom of bulimia nervosa and the bulimia should not be ruled out because someone does not have face swelling. 

Impacts on Teeth And Bulimia

Those with bulimia nervosa may experience dental caries and dental erosion. 

This is a result of: 

  • Changes in pH of the mouth with continuous vomiting 
  • Changes in bacteria of the mouth
  • Dry mouth 
  • Decreased salivary flow 
  • Lower ability for saliva to acquired pellicle (a defense against acid erosion)

Gastric acid which has a pH of 2.7 begins to dissolve tooth enamel. 

Long Term Effects Of Bulimia Nervosa

Bulimia Nervosa Impacts On The Heart

Bulimia can have both short and long term impacts on the heart. Some of the impacts on the heart you may see in bulimia are: 

Many changes to the heart that occur with bulimia nervosa are reversible with supervised weight restoration. 

However, it is very important to note that the rapid electrolyte shifts that occur with purging can cause the heart to stop at any time. This can lead to neurological damage that can’t be reversed or death. 

infographic on long term effects of bulimia

Impacts On the GI Tract Of Bulimia Nervosa 

Bulimia nervosa has impacts on the GI tract which include: 

  • Delayed gastric emptying 
  • Cathartic colon syndrome (colun is unable to move stool resulting in severe constipation)
  • Nausea
  • Cramping 
  • Pancreatitis (inflammation of pancreas)
  • Kidney stones

Delayed gastric emptying can cause you to feel extreme bloating, pain and early fullness. This can make it even more difficult to eat which worsens the condition. Weight restoration can help with delayed gastric emptying. 

Different GI symptoms may occur with different types of purging (vomiting versus laxative abuse) Fox example, laxative abuse is more likely to result in pancreatitis and kidney stones. 

Stomach relaxation after meals is significantly reduced in patients with bulimia nervosa. 

Bulimia Nervosa Impacts On The Bones

Bulimia nervosa can lead to a decrease in bone mineral density.  This can have long term impacts on health leading to osteopenia (weak bones) or osteoporosis. 

Bone loss in patients with bulimia can be related to: 

While some bone mineral density restoration is possible once weight is restored and normal nutrition is resumed, some impacts may be lasting. 

The long term risks of bone disease in those with bulimia will depend on: 

  • How long someone goes without a period
  • The level of calcium deficiency 
  • The intensity of the physical activity that was done 

Damage To The Esophagus and Throat With Bulimia Nervosa 

Frequent vomiting that occurs in bulimia can lead to effects such as: 

Purging through vomiting can cause the upper GI tract to bleed. The stomach becomes irritated by stretching following a binge and then vomiting. This can produce ulcers as well.

While some of these symptoms impacting the GI tract with bulimia are reversible, some such as GERD or Barrett’s esophagus may be lifelong.  Symptoms such as Boerhaave syndrome are uncommon but can be deadly.

What Does Bulimia Do To The Brain? 

Structural changes can occur in the brain of someone with bulimia nervosa including 

  • Enlarged ventricles 
  • Sulcal widening (often seen with aging)
  • Nodal strength changes in sensorimotor and visual regions, hippocampus, and orbitofrontal cortex. 

The structural anatomy of the brain and the reward systems are altered with bulimia nervosa. 

People with bulimia nervosa are likely to experience extreme food guilt after eating.

Structural changes in the brain make it critical to have a support team in place to help a person with bulimia nervosa with meal support challenging fear foods and following their meal plan as they often cannot do it alone.    

Can Bulimia Nervosa Cause Permanent Damage? 


Bulimia can have long term irreversible impacts on: 

  • The heart
  • The gastrointestinal tract 
  • Bone mineral density 
  • The throat and the esophagus 

There is no safe way to engage in purging behaviors associated with bulimia nervosa. There will be short term and potentially permanent complications from the disorder if qualified medical and therapeutic intervention are not sought out as early as possible. 

Can the Body Fully Recover From Bulimia? 

The extent to which the body is able to recover from bulimia will depend on: 

  • How long the symptoms of bulimia have been occuring 
  • The extent to which purging of any sort occured 
  • The level of nutritional intake the person consumed during and after their eating disorder
  • Compliance with the treatment program 
  • Compliance with the eating disorder recovery meal plan 
  • Ability to appropriately restore weight 
  • Access to care 

While unfortunately some effects of bulimia nervosa will not be reversible. It is critical that treatment with a qualified healthcare team is received as soon as possible in order to prevent any further physical damage to the body. 

How Can I Prevent Effects of Bulimia? 

The best and only way to prevent permanent damage from bulimia nervosa is to initiate eating disorder treatment intervention as early as possible. 

Even if someone is at a point where they are suffering long term consequences of bulimia, treatment is critical to prevent any physical damage from bulimia  from getting worse. 

If you’re looking for more support and resources on your recovery journey, check out these eating disorder recovery books.  

A full recovery from your eating disorder IS possible and you deserve to live a life free from rules and rituals around your food and your body.  

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What Is Bulimia Face?

Bulimia face is the swelling of the face as a result of self-induced vomiting producing swollen salivary glands. The person often has the appearance of “chipmunk-like” cheeks.

Are The Effects of Bulimia Reversible?

Some effects of bulimia are reversible while others may be lifelong. The effects of bulimia will depnd on How long someone goes without a period, how early intervention took place, and how severe eating disorder symptoms were.

What Are The Physical Long-Term Impacts Of Bulimia Nervosa

Bulimia can have long-term impacts on the heart, the gastrointestinal tract, the bones, the teeth the esophabus.

Shena Jaramillo. Registered Dietitian

Hi I'm Shena. I'm an eating disorders dietitian in Washington state. I hold bachelors degrees nutrition & dietetics, cultural anthropology & psychology. I believe in honoring your hunger, having your cake whenever you want it, and that critically analyzing diet culture can change the world!