Leicestershire Adult Eating Disorders
Service
Health problems resulting from eating
disorders
Repeated Vomiting
This leaflet provides information for patients about some of the
physical problems that may result from repeated vomiting. The
aim of this leaflet is to provide you with information that is
important to you, not to worry you or upset you. The information
in this leaflet may raise questions to discuss with your doctor or
therapist. It will help explain why you may need certain blood
tests or other investigations.
Leicestershire Adult Eating Disorders Service
Leicestershire Partnership NHS Trust
Bennion Centre
Groby Road
Leicester
LE3 9DZ
Tele: 0116 225 2557
Author: Dr Hugh Herzig
Reviewed: March 2013
Review due: June 2014
Repeated self-induced vomiting
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Many people with eating disorders make themselves
vomit. This can become frequent and habitual, and
difficult to change. Sometimes people describe it as
having become an almost automatic reflex after
eating.
As well as getting rid of food and controlling body
weight, vomiting may come to be a means of dealing
with distressing feelings, or become a kind of selfpunishment. With binge eating it may form a vicious
circle, each problem reinforcing the other and making
change still harder.
Many people are surprised to learn that in fact
vomiting after eating is not a good method of getting
rid of food. When the stomach suddenly contracts to
vomit, around 50% of its contents are pushed further
down into the intestine where they will be digested
and absorbed. Only half the food is expelled.
Whilst half of the food contents of the stomach stays
in the body, vomiting does cause a great loss of
certain essential minerals. The habit of attempting to
wash out all stomach contents by repeatedly drinking
water and vomiting hastens this mineral loss. These
minerals make up the acidic stomach fluid important
for the breakdown and digestion of food.
Health problems caused by repeated vomiting
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The most important mineral to be depleted by
repeated vomiting is potassium, but there are
others such as phosphate, calcium, zinc and
magnesium.
Potassium is vital to life because of its role in nerve conduction,
particularly the nerves and muscles of the heart. So when
potassium levels in the body fall, the heart may lose its regular
beating rhythm. This may cause faintness or even loss of
consciousness. Occasionally the heart may stop beating
altogether.
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Your doctor or therapist may check the potassium level with a
blood test and the heart rhythm with an ECG
(electrocardiograph). You may be prescribed potassium tablets
or need admission to a medical ward, where intravenous drip
potassium replacement can be given safely.
Of course these measures won’t help for long if the frequent
vomiting continues. The only lasting way to maintain normal
safe potassium levels is to decrease and stop vomiting.
Repeated vomiting, laxative misuse, and misuse of diuretics
(water tablets) all lead to significant mineral and fluid loss
including potassium. In combination these behaviours are
particularly risky.
In addition to the dangerous effect on the heart, repeated
vomiting commonly leads to other health problems. Low
potassium can in time lead to kidney disease. Frequent
vomiting is likely to cause dehydration, bringing faintness,
tiredness and headache.
Acidic stomach fluid in the mouth erodes dental enamel, and
sometimes it is the dentist who first notices and asks about the
problem of frequent habitual vomiting, which has been kept
secret from others. Dentists advise against brushing teeth
straight after vomiting, as this worsens the acid damage.
Instead you should rinse with water and then rinse with a
fluoride mouth wash or even with a small amount of high
fluoride tooth paste The only way to protect your teeth
properly is to stop vomiting
In reaction to frequent vomiting the saliva glands in the cheeks
may enlarge, giving the face a swollen appearance. This
swelling may be misinterpreted as weight gain and cause
further distress and vomiting.
Frequent vomiting also results in damage and bleeding of the
esophagus, which may cause pain, blood loss, and anaemia.
If you have any questions or concerns about the information in this
leaflet you can raise these with your doctor or therapist or leave a
message with our secretaries on 0116 225 2557.