| Summary: | Abstract Background Bulimia nervosa (BN) and the binge‐eating/purging subtype of anorexia nervosa (b/p AN) are characterized by binge eating and unsafe compensatory behaviors, such as laxatives or diuretic abuse, self‐induced vomiting, and excessive exercise. BN often causes miscellaneous physical complications that can lead to death. However, there have been very few prior reports on the physical complications of chronic BN. Case Presentation We report a case of chronic BN of over 10 years. Her compensatory behaviors caused dehydration more easily than before. Repeated dehydration may result in end‐stage renal disease (ESRD). Therefore, we had to prevent dehydration by placing a percutaneous endoscopic gastrojejunostomy (PEG‐J) tube. After PEG‐J placement, dehydration did not reoccur, thereby protecting her renal involvement from progressing to ESRD. Conclusion Chronic BN exposure may cause repeated dehydration with time. Therefore, the PEG‐J tube would be effective in preventing dehydration, which leads to ESRD.
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