Electrolytes often come up when discussing athletes, but these essential minerals are important for everyone, regardless of their activity level.

Still, certain eating disorders, including bulimia nervosa (BN), may cause an imbalance in electrolytes. This can lead to a cascade of health conditions that can have long-term effects.

What are Electrolytes?

Electrolytes are a group of essential minerals that help the body perform a number of key functions. Primarily, they help generate and regulate electrical charges throughout the body, while also contributing to the regulation of fluid levels.

The body utilizes a range of electrical impulses to help stimulate many necessary functions. Electrical pulses help contract muscles, including the heart, and are a key part of many chemical reactions, including the production of hormones. Electrolytes ensure these signals continue on a steady, healthy rhythm.

Trace amounts of these substances are found in water, but the body can also get electrolytes from a variety of other beverages and foods.

What are the Effects of Electrolytes on the Body?

There are many different types of electrolytes, and while each of them are important in their own right, a few of these nutrients and minerals are involved in particularly important functions, including: [1]

Calcium: This mineral is involved in nerve impulses, which can help with contracting muscles, secreting hormones, and blood clotting.
Chloride: Various nutrients, bodily fluids, and oxygen and carbon dioxide levels are regulated with chloride. It also helps maintain pH levels.
Magnesium: This mineral is important for proper nerve and muscle function and the production of energy.
Phosphate: The enzymic reactions in cells that produce energy are catalyzed by phosphate.
Potassium: This mineral helps regulate heartbeat and helps the body process carbohydrates and protein.
Sodium: Muscle contract and relaxation is done with the help of sodium, as well as fluid level maintenance and certain nerve impulses.

How Does Bulimia Contribute to Electrolyte Imbalance?

When someone struggles with bulimia nervosa (BN)—particularly, purging type bulimia nervosa—they’re at an increased risk of electrolyte imbalance.

That’s because many purging options for people with this eating disorder will result in imbalanced electrolyte levels.

Self-induced vomiting frequently contributes to the depletion of electrolytes in the body, as many of these nutrients and minerals are derived from the food and beverages people in these instances are expelling from their bodies.

And laxative abuse, another common purging method for many people with BN, also can lead to electrolyte imbalances. In particular, laxatives tend to deplete the body of potassium, which can lead to a number of serious health issues.

Individuals with bulimia nervosa may also develop what is known as hypovolemic hyponatremia. This condition occurs when the body is chronically depleted of fluid—a contributing factor to electrolyte imbalance—which can result from purging behaviors over time.

Possible Consequences of Electrolyte Imbalance

While electrolytes are vital to the body in general, the levels of each must be in the correct proportion to remain healthy.

A disruption in the electrolyte balance in the body can cause a cascade of health problems. And long-term electrolyte imbalances can lead to permanent conditions in many systems of the body.

Hypokalemia

Hypokalemia occurs when potassium levels are low. Muscle cramps are the most well-known symptom of low potassium levels, but there are other symptoms of this condition, including:

Heart palpitations
Fatigue
Numbness or tingling
Constipation
Heart arrhythmia
Excessive thirst or urination

While potassium has many important jobs in the body, it is particularly important for proper heart function. As such, hypokalemia could lead to heart health complications. [4]

Metabolic Acidosis

Metabolic acidosis is another common side effect of low potassium levels. It occurs when too much acid builds up in bodily fluids.

Low potassium levels can lead to trouble regulating fluid levels in the body, which can lead to this type of imbalance.

Signs of metabolic acidosis include:

Rapid heartbeat
Fatigue
Loss of appetite
Confusion
Headaches.

If left untreated, metabolic acidosis can worsen, leading to kidney disease and endocrine disorders. [5]

Pseudo-Bartter Syndrome

Electrolyte imbalance in people with BN may also lead to the development of a rare kidney disorder called Pseudo-Bartter syndrome.

Frequent vomiting, misuse of laxatives, or overuse of diuretics can all contribute to developing this condition, which leads to low levels of potassium and chloride in the blood, and a number of related health concerns. [2, 6]

Bulimia, Electrolyte Imbalance and Heart Health

Both short and long-term heart health is also a major concern for individuals who experience bulimia nervosa. The disruption of electrolytes that occurs as part of the purging cycle has a drastic effect on the heart.

Vomiting, diuretics, and laxatives can all affect the level of potassium in the blood. When this happens, weakening of the heart, known as cardiomyopathy, may develop. Low potassium levels can also lead to heart arrhythmia and involuntary muscle contractions. [7]

Several common purging methods also lead to higher levels of sodium in the blood. This can lead to confusion, involuntary twitching of the muscles, and even seizures. [7]

Prolonged electrolyte imbalance could contribute to a major cardiac event. This is one reason why it’s crucial to seek help for bulimia nervosa as quickly as possible.

Finding Help for Bulimia Nervosa

If you or a loved one are struggling with bulimia nervosa, it’s important to reach out for help.

Speaking with your physician or mental health therapist may be a great place to start. These healthcare professionals are often trained in how to help, or know of programs or other resources for treatment.

The most important thing to remember is that help is always available. Reaching out may be scary, but it’s the first step toward a healthier and happier future.

Resources

Fluid and Electrolyte Balance. (2016, June 20). MedlinePlus. Accessed January 2023.
Bartter Syndrome. (2023). National Organization for Rare Disorders. Accessed January 2023.
Bahia, A., Mascolo, M., Gaudiani, J. L., & Mehler, P. S. (2012). PseudoBartter syndrome in eating disorders. The International journal of eating disorders; 45(1):150–153.
Electrolytes. Cleveland Health Clinic. Accessed January 2023.
Metabolic Acidosis. National Kidney Foundation. Accessed January 2023.
Nitsch, A., Dlugosz, H., Gibson, D., Mehler, P.S. (2021). Medical complications of bulimia nervosa. Cleveland Clinic Journal of Medicine; 88(6):333-343.
Zepf, B. (2004). Metabolic Abnormalities in Bulimia Nervosa. American Family Physician; 69(6):1530-1532.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

Last Updated on March 24th, 2023
Published on EatingDisorderHope.com

Electrolytes and Bulimia: Why Is This a Big Deal?