Abstract

Background: Bulimia nervosa (BN) is a chronic mental health disorder that can be associated with numerous medical complications. Patients with BN are often impulsive, and they often engage in activities that are harmful towards themselves and others.

Objective: To have a firm understanding of the medical complications of BN so that effective medical treatment can be provided in a timely and effective manner to help achieve a successful treatment outcome in BN; To appreciate the medico-legal issues that may arise in patients with BN.

Results and Conclusions: The medical complications of BN are secondary to the compensatory purging behaviors used by patients to help prevent weight gain and include self-induced vomiting, over-exercise, and misuse of diuretics, diet pills, and laxatives. Medical complications can be severe, are sometimes irreversible, and can occasionally be life-threatening. It is prudent to make patients aware that medical complications such as syncope and seizures, as well as a propensity for sudden cardiac death, could limit their ability to drive safely, and may lead to unwanted legal consequences should they become impaired while driving and injure another party. Clinicians must also be astute regarding the high risk of self-harm and suicide in patients with BN.

Keywords: Bulimia nervosa, purging, hypokalemia, laxative abuse, pseudobartter’s edema, self-harm.

Graphical Abstract