How does bulimia cause internal bleeding?

Bulimia can lead to internal bleeding primarily due to repeated episodes of vomiting, which can cause tears in the esophagus (known as Mallory-Weiss tears) and damage to the lining of the stomach. Additionally, the frequent purging can result in electrolyte imbalances and gastric distension, further increasing the risk of gastrointestinal bleeding. The use of laxatives, often associated with bulimia, can also irritate the intestines and lead to complications. Overall, the combination of these factors can contribute to serious internal injuries and bleeding.