Signs & Symptoms

Physical complications:

• Cardiovascular: arrhythmias, decreased BP, sudden cardiac death, peripheral oedema
• MSK: decreased muscular strength, atrophy, decreased bone density, fractures, decreased growth
• Endocrine: thyroid abnormalities, impaired secondary sexual characteristics
• GI: constipation, abnormal LFTs, enlarged prostate gland
• Haematological: pancytopenia
• Metabolic: refeeding syndrome (low potassium, phosphate and magnesium)
• Neurological: cognitive decline
• Skin: dry skin, alopecia, lanugo hairs
• Reproductive: infertility, PCOS, amenorrhoea, sexual dysfunction
• Dental: dental erosion (secondary to vomiting)
• Renal: stones

Specific to bulimia:

• Aspiration pneumonitis
• Mallory-Weiss syndrome
• Oesophageal ruptures
• Russell’s sign (knuckle calluses from vomiting)