These cycles often involve rapid and out-of-control eating, which may stop when the bulimic is interrupted by another person or the stomach hurts from overextension, followed by self-induced vomiting or other forms of purging. This cycle may be repeated several times a week or, in more serious cases, several times a day, and may directly cause:
* Chronic gastric reflux after eating
* Dehydration and hypokalemia caused by frequent vomiting
* Electrolyte imbalance, which can lead to cardiac arrhythmia, cardiac arrest, and even death
* Esophagitis, or inflammation of the esophagus
* Oral trauma, in which repetitive insertion of fingers or other objects causes lacerations to the lining of the mouth or throat
* Gastroparesis or delayed emptying
* Constipation
* Enlarged glands in the neck, under the jaw line
* Peptic ulcers
* Calluses or scars on back of hands due to repeated trauma from incisors
The frequent contact between teeth and gastric acid, in particular, may cause:
* Severe caries
* Perimolysis, or the erosion of tooth enamel
* Swollen salivary glands