Dear Alice,

I have been a bulimic for over two years and I am indecisive about whether or not I should get help. I would like to know about the long term and short term effects of this eating disorder. I would also like to know whether or not I can prevent these long term effects if I decide to quit in the near future because at this moment I have fourteen new cavities (which I'm currently getting fillings for) and one partially decayed tooth (which the dentist was barely able to save) and I have swollen salivary glands (which I hope are irreversible because they make me look like a chipmunk).

—Theodora

Dear Theodora,

You have listed many of the effects of bulimia on your body. Most of the physical problems associated with bulimia arise from vomiting. It is the most "effective" way of purging, and it is also the most physically destructive. Repeated exposure to the acid in vomit demineralizes teeth. Your teeth may become sensitive to heat, cold, and acids. Eventually, your teeth may severely decay, erode away from fillings, and finally fall out.

Your blood potassium levels can drop significantly with regular vomiting or use of certain diuretics. This can disturb your heart's rhythm and even produce sudden death. Salivary glands may swell because of infection and irritation from the vomit. You may at some point suffer from stomach ulcers and bleeding and tears in your esophagus. Constipation may result from frequent laxative use. When bulimic episodes occur over time, a sequence of chronic illnesses can occur affecting your heart, liver, gastrointestinal tract, and/or neurologic complications.

Unfortunately, the damage to your teeth is probably irreparable. Your swollen glands should go down once you stop the cycle of bingeing and purging. Some of the longer term effects, which it sounds like haven't reached you yet, are life-threatening and irreversible. It sounds like you are well-aware of your condition, which is a crucial step in being ready to seek help. The next step is to seek help from a professional counselor or health care provider. Although it may seem intimidating, difficult, or even unpleasant to talk with someone about your eating patterns, it is the best way to address your health concerns. What's more, you deserve the help and support a professional can provide to you.

If you're a college student, there may be resources and support available to you; consider reaching out to your campus' health services to see what they offer. You might also try the National Eating Disorders Association for referrals, assistance, support, and other information.

You have begun to experience some of the serious side-effects of bulimia, but you don't have to continue down that path. By seeking help you can work toward correcting your current medical problems and overcoming bulimia.

Wishing you courage and strength,

Alice!

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