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Lifestyle Modifications : Encourage stress reduction techniques, adequate sleep, and regular physical activity as tolerated

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Medical Some of the medical impacts and complications associated with bulimia nervosa include: Chronic sore throat, indigestion, heartburn and reflux Inflammation and rupture of the oesophagus and stomach from frequent vomiting Stomach and intestinal ulcers Chronic irregular bowel movements, constipation and/or diarrhoea due to deliberate misuse of laxatives Heart problems including slow heart rate, irregular heartbeat and low blood pressure Electrolyte disturbance, including potassium and sodium Osteoporosis or osteopenia: a reduction in bone density caused by a specific nutritional deficiency Fatigue and lethargy Loss of or disturbance to menstruation Increased risk of infertility Death Psychological Some of the psychological impacts and complications associated with bulimia nervosa include: Extreme body dissatisfaction/distorted body image Obsessive thoughts and preoccupation with eating, food, body shape and weight Social withdrawal Feelings of shame, guilt, and self-loathing Depressive or anxious symptoms and behaviours Self-harm or suicidality Substance misuse Recovery It is possible to recover from bulimia nervosa, even if a person has been living with the illness for many years

Second, dose matters more than most people realize