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Weight loss: side effects of overeating or vomiting during bulimia nervosa WEIGHT LOSS: SIDE EFFECTS OF OVEREATING OR VOMITING DURING BULIMIA NERVOSA
Binge eaters, of course, don't worry too much about a balanced diet, but the consequences of malnutrition also include hair loss, discoloring or softening of the fingernails, and weakness. And of course, just as you've been told since the age of two, eating too many sweets can indeed ruin your teeth. Two pounds of M&M's and a gallon of ice cream a day won't win you many points with the American Dental Association.
After a year or two of constant vomiting, a patient may end up with crumbling, ugly teeth. The most common symptom is perimolysis-dental erosion due to calcium loss brought about by the acid in the vomitus - but patients wind up with a lot of cavities as well. Some report that their teeth are abnormally sensitive to temperature changes. Many bulimics, aware of the danger, try to compensate by brushing vigorously after each vomiting episode. Ironically, overenthusiastic scrubbing only hastens erosion. Eating-disordered people may eat a lot of citrus fruit or candy to stave off hunger, which further damages teeth. Starvation and malnutrition also weaken the bones of the jaw.
Disordered eating and purging may lead to chemical imbalances in the brain. Consequently, bulimics may experience sleep difficulties as well as mood changes such as depression.
Vomiting does more than just remove food. The bitter taste of vomit comes from the mix of stomach acid and other digestive juices secreted during the process of eating. Your body works hard to make that juice. Like little factories, the pancreas, the liver, the gallbladder, and other organs manufacture different enzymes and other substances to enable you to break down fats and absorb calories. Those substances are made up of proteins, minerals, and other elements that were absorbed from previous meals and stored in these organs.
Thus, when you throw up, you not only remove nutrients you need now, but you also deplete the reserves of those nutrients absorbed during previous meals. Without these life-giving substances, your heart can't function properly, nor can your other muscles and tissues. As a result you may experience weakness, fatigue, constipation, depression, even heart failure. Another serious complication can arise for those patients who use ipecac to induce vomiting. Ipecac is a nonprescription medicine used to trigger vomiting after accidental poisoning. Unfortunately, repeated use of ipecac may weaken muscles (including the heart); fatal heart difficulties have occurred in a number of bulimic patients who abused this drug.
The loss of chemical building blocks also makes it harder to manufacture the hormones needed to regulate various body systems, including the reproductive system. By definition, all anorexics experience loss of menstrual periods; about 20 percent of bulimics become amenorrheic, while about 50 percent experience menstrual irregularities.
Poor eating habits affect the brain and the nervous system. Some eating-disordered patients show abnormalities on brainwave (electroencephalograph, or EEG) tracings. Just what this means medically, however, is not yet clear. Sleep is affected too; bulimics may enter the rapid-eye movement (REM) phase of sleep sooner than normal. Disturbed sleep at night means fatigue the next day. Some patients report feeling muscle spasms or tingling sensations.
Vomiting removes a lot of fluid. So does abuse of laxatives and diuretics. Such practices can lead to chronic dehydration, which in turn poses the risk of permanent kidney damage.
Using laxatives is like locking the barn door after the horse has escaped. By the time food enters the large intestine, nearly 90 percent of its calories have already been absorbed anyway. In the course of a day, laxatives might help you get rid of the caloric equivalent of one measly candy bar.
But is it worth it? The risks of laxative abuse include dehydration, poor absorption of food and its nutrients, abdominal and muscular cramps, mineral imbalances, and swelling or clubbing of the fingers. Some of my patients admit taking anywhere from four to a hundred (!) laxative tablets every day.
Abuse of laxatives can cause the bowel to become dependent on these substances to function normally. The bowel loses its ability to contract in a coordinated way to move the fecal material along. A kind of backup in the biological sewage system results, leading to bloating and abdominal distension. When the patient stops taking laxatives, severe constipation may occur, in some cases requiring surgical intervention.
Some bulimics try to control appetite through excessive use of diet pills, which may contain the stimulants known as amphetamines. Side effects of these substances include mood changes, irritability, fatigue, and insomnia. The attempt to suppress appetite artificially only works for so long; eventually, the desire to eat becomes overwhelming. Thus, ironically, the use of appetite suppressants might actually lead to an eating binge. Another stimulant widely abused by bulimics is caffeine, both to suppress appetite and to improve mood and energy level.
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WEIGHT LOSS
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