Persons with bulimia are often aware that their eating patterns are abnormal and out of control and that their lives are dominated by their eating habits. They may feel quilty and depressed after a binge. Over time, the cycle becomes more and more dominant in the person's thoughts and behavior. It may impair personal relationships and interfere with other activities, leading to depression, isolation, and lowered self-esteem. Once caught in this pattern, the resulting shame and sense of helplessness may make it difficult for the person to seek the help that is needed. .
Physical effects can also be serious.
Frequent vomiting can cause permanent tooth damage from erosion of tooth enamel as well as damage to the tissues of the throat and esophagus. Kidney problems and seizures are also possible. Electrolyte imbalance with consequent risk of serious cardiac problems is also a significant danger. In these cases persons turn to binge-purge strategies as an alternative to starving themselves to achieve their desired weight loss. Thus the bing-purge cycle may occur in both disorders but individuals with anorexia nervosa lose much more weight.