How Does Bulimia Cause Hair Loss?

There are two main ways that bulimia causes hair loss.

The first is shared with anorexia and comes when bulimics lose the proper nutrition needed to support healthy hair growth. New hair requires resources the body can use elsewhere when nutrition is lacking. This first type of hair loss is gradual and shows up as a thinning over time. New hair isn’t growing in fast enough to replace lost hair.

The second cause is more dramatic. It’s called telogen effluvium. It can be caused by emotional or physical stress that goes on for an extended period – bulimia is a known cause.

The telogen phase of hair growth is a resting phase where hair is not actively growing and during which hair is naturally shed. The hair follicle rests before producing another hair. In normal growth, this phase lasts about three months with the growth phase lasting several years before this rest phase. In bulimia, the telogen phase is reached early, the follicle rests and the hair falls out.

When a large amount of hair goes into the telogen phase, we see it as shedding of visible clumps of hair. For bulimics, where appearance is a motivation to purge, this hair loss can be devastating. The distorted body image makes it feel even worse.

Here is a description from a bulimic:

”I was always known for my long, dark, thick hair; but as my bulimia progressed, so did the hair loss. I dreaded showers just for the sick feeling in the pit of my stomach that followed every time I ran my fingers through my hair and pulled out first strands, then large clumps. It got so bad I refused to even go to my long time hair dresser because she would notice and I was so ashamed. I got close to buying Rogaine, but couldn’t face the questioning look of the girl my age at the checkout counter…”

Rogaine is not a useful treatment for telogen effluvium. However, this person eventually got well, and her hair returned to normal. This is common when bulimics begin to recover from the eating disorder and return to normal eating habits. Unfortunately, complete return of a full head of hair can take months to a year.