Hanoi doctors warn bulimia is going unnoticed until young patients collapse

Clinicians at Bach Mai Hospital say delayed diagnosis of bulimia can cause dangerous electrolyte imbalances, including low potassium and potentially fatal heart problems.

Doctors in Hanoi are warning that bulimia nervosa, a serious eating disorder marked by cycles of uncontrolled overeating and attempts to undo the calories consumed, is appearing increasingly among young people and can become life-threatening if it is missed. At a health communication forum on 12 October, Nguyen Van Tuan, director of the Institute of Mental Health at Bach Mai Hospital, said delayed diagnosis can be dangerous because patients may develop severe electrolyte problems that, in extreme cases, lead to death.

The warning followed accounts from clinicians of young patients whose symptoms were overlooked until their physical health began to deteriorate. One 21-year-old university student from Tuyen Quang came to the Institute of Mental Health after repeated binge-eating episodes, self-induced vomiting and misuse of laxatives and diuretics. She had also been using fasting, tea and coffee to lose weight after being mocked about her appearance at university. Clinicians said she was diagnosed with bulimia nervosa and low potassium, a complication that can trigger weakness, fainting and dangerous heart rhythm problems.

A second case involved a male final-year student from Nam Dinh whose family did not realise how severe his eating problems had become. Friends noticed that he often ate far more than his peers, sometimes consuming several meals in one sitting. He later fainted after vomiting, prompting relatives to learn that he had been making himself sick regularly. After more than a month of outpatient treatment, his condition had improved by about half to two-thirds, clinicians said. Medical sources such as Johns Hopkins Medicine note that bulimia often follows a repeated pattern of bingeing and purging and that early treatment is strongly linked to better outcomes, while research reviewed in PubMed shows the disorder commonly begins in adolescence or early adulthood and is seen more often in girls and young women.

Doctors at Bach Mai Hospital said parents and caregivers should watch for warning signs such as rushing to the bathroom straight after meals, hiding evidence of vomiting, disappearing food, rigid dieting mixed with episodes of overeating, excessive exercise, or secret use of laxatives and diuretics. They also urged families to take note if a young person avoids eating with others, becomes withdrawn, or shows marked mood changes around mealtimes. Because the physical damage can build quietly, experts said early specialist assessment is essential, particularly where low potassium or other signs of electrolyte imbalance are suspected.