Bingeing followed by purging is extremely hazardous to your physical health. Taking emetics like ipecac is literally putting poison into your body, and you know that poison can kill. Misuse of ephedra-based supplements contributes to heart attack and strokes. In extreme instances, vomiting can cause your stomach to rupture (burst open). It can also cause something called alkalosis, which involves chemical changes in your blood resulting in a loss of calcium in your system, as well as tingling in your fingers, tetany (a series of uncomfortable muscle spasms in various body parts, often the legs), and damage to your liver, lungs, and heart. The acid in your stomach that is a component of the vomit can burn your esophagus, cause scar tissue to form, destroy the enamel of your teeth and create sores inside your mouth.
Repeated laxative abuse is a dangerous and misguided practice. It can destroy your bowel function and leave you with perpetual diarrhea and rectal bleeding. It can also deplete the sodium and potassium levels in your system (as do diuretics), which can then cause your heart to beat irregularly. In extreme cases, it can lead to heart failure, which can kill you. Ironically, laxatives don't really cause weight loss because they act on the lower portion of the gut, and calories are absorbed higher up. Also, laxatives produce watery stools, and any resulting weight loss is due to a loss of water.
If you misuse diuretics, you may find you have a lot of swelling in your body, especially noticeable in your fingers. This is a condition called idiopathic edema and it is most common in young women. It's uncomfortable, makes you think you're fat when in fact you're just swollen, and perpetuates an urge to purge because of the way you mistakenly read a body signal. You may find that your legs react to this self-imposed physical abuse: due to the loss of potassium in your system, they might throb, hurt when you put stress on them, or have little or no strength to support you even in the simplest act of walking.
If you're female, bulimia can cause menstrual irregularity, but a study done at the University of Minnesota Medical School has found that bulimia appears to have no long-term impact on a woman's ability to become pregnant (American Journal of Psychiatry2002; 159:10481050).
Early into a binge you may feel free and less tense, but by the time you conclude a binge and begin the purging, that easing of tension can give way to feelings of guilt about what you've done. You might experience a lot of negative self-talk, a sense of hopelessness and resignation that there is no alternative but to yield to the purge, a belief that you're "bad," "worthless," and deserve the self-punishment of the purge. Those negative, uncomfortable feelings will lead to more tension, and then the conditions which gave rise to the cycle in the first place will begin again.
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