PHYSICAL PROBLEMS/MEDICAL COMPLICATIONS

Eating Disorders have a multitude of medical complications ranging from mild to severe. In Anorexia, for example, it is believed that 5-20% of anorexics die, usually from complications associated with self-starvation, such as: heart, kidney, or multiple organ failure, or illnesses like pneumonia, which may be due to an inability to fight infection—all ultimately due to the anorexia. Studies show that the longer one has anorexia, the higher the mortality rate. Someone who has been anorexic for five years has about a 5% chance of mortality, but the rate increases to 18% in individuals who suffer chronically for 30 years (Reference: Kathryn Zerbe p. 250).

Let’s take a closer look at some of the complications that can arise during the course of eating disorders:

Cardiac Problems 

Starving, bingeing, and purging all lead to electrolyte imbalances. Electrolytes, are chemicals like sodium, potassium, and chloride. They help regulate your heartbeat. When dehydration occurs, from purging, diuretic & laxative abuse, electrolytes like potassium are lowered, which typically result in cardiac arrhythmia, an irregular heart beat—too fast, too slow, or lacking the proper rhythm. Some arrhythmia aren’t dangerous and may subside once the body is restored to health. Others arrhythmias are extremely dangerous and can lead to cardiac arrest. It’s a bit like playing Russian Roulette, there are no guarantees as to who develops an arrhythmia or other severe consequence.

The heart’s size can also be affected. When people starve and lose weight, they do not lose only fat, they also lose muscle mass. Since the heart itself is a muscle, starvation can lead to decreases in both mass and chamber size.

For the heart to beat, lungs to work, and blood to travel through our veins, the body requires energy. Starving causes an energy crisis, in response to which the body literally slows down to conserve what little energy it has left in order to perform the basic functions required to sustain life. In addition to the metabolism slowing down, the heart rate also slows down, a condition called “bradycardia.” Most women’s hearts average ap- proximately 80 beats per minute, but some anorexics have had heart rates as low as 25 beats per minute (Kaplan 1993, p. 73).

Gastrointestinal disorders 

One of the most common problems experienced by those with eating disorders is delayed gastric emptying, which essentially means that food leaves the stomach slower than it would if the body were healthy. When this happens complain that they feel unduly bloated and “stuffed” after consuming only a modest meal, some feel full after only a few bites. While this discomfort is founded in a real physical condition, it does tend to subside once eating is normalized.

Those who vomit are at risk for internal bleeding, ulcers, and gastritis, a painful inflammation of the stomach lining. Vomiting can cause a painful swelling of the esophagus, and places undue stress on the stomach, both of which are at risk of rupturing, a condition which is fatal unless immediate medical attention is available. It also often causes tearing of the esophagus, and people will see streaks of blood in their vomit. Vomiting also causes enlarged parotid (salivary) glands sometimes described as “chipmunk cheeks,” loss of the gag reflex, and has been linked to the development of hiatal hernias.

Constipation is a common condition resulting from inadequate fiber and food intake. Some individuals have such reduced intestinal motility that medical attention is required. Laxative abuse and overly aggressive refeeding both pose a risk for bowel perforations, which may call for surgical intervention. The small intestine also frequently becomes ineffective in absorbing nutrients and minerals.

ANOREXIA NERVOSA:

Amenorrhea (loss of menstruation)
Anemia
Bingeing (side effect of starvation)
Bloating
Bowel bleeding and perforation (result of laxative use)
Bruising easily
Bradycardia (slow heart rate)
Cardiac arrhythmia (irregular heartbeat)
Cardiac arrest
Cathartic Colon (result of laxative use)
Constipation
Decreased heart mass and chamber size
Decreased metabolic rate
Decreased testicular function
Dehydration
Delayed gastric emptying (causes person to feel bloated and full after only a small meal or even a few bites)
Dental decay and/or discoloration
Depressed immune system
Dizziness
Dry skin, brittle hair and nails
Edema (water retention, most common in ankles or feet)
Electrolyte imbalances (can lead to cardiac arrhythmia and death)
Endocrine abnormalities
Esophagitis (painful swelling of the esophagus due to vomiting)
Fainting
Hiatal Hernias (effect of vomiting)
High cholesterol (effect of starvation, low cholesterol diet not usually necessary)
Hyperactivity
Hypoglycemia (low blood sugar)
Increased risk of osteoporosis (bones lose density and fracture easily)
Insomnia
Ketosis (excessive accumulation of ketone bodies in the blood and urine indicative of the body digesting its fat stores as a sole source of energy. Can be quite dangerous)
Kidney damage or failure (usually the result of dehydration often worsened by diuretic use)
Lanugo (fine downy hair on the body)
Liver damage (condition that is irreparable, e.g. nutritional hepatitis)
Loss of hair on the head
Low blood pressure
Low body temperature (causes person to feel cold easily)
Malabsorption syndrome (small intestine becomes ineffective at absorbing vitamins and minerals)
Muscle cramps and weakness (usually caused by electrolyte imbalances)
Pancreatitis (painful swelling of the pancreas evidenced by severe abdominal pain, distension and fever)
Reduced intestinal motility (result of laxative use)
Sensitivity to light and sound
Yellow skin (hypercarotinoma)

BULIMIA NERVOSA:

Amenorrhea (loss of menstruation) Oligomennorhea (abnormal menstruation)
Anemia
Blistered esophagus
Bloating due to gas
Bowel infections (result of laxative or enema use)
Bowel tumors
Cardiac arrhythmia (heart beats too fast, too slow or lacks proper rhythm can lead to cardiac arrest and death)
Cathartic Colon
Constipation
Decreased intestinal motility
Dehydration
Dental decay and or discoloration
Diarrhea
Dizziness
Edema (water retention)
Electrolyte imbalances (usually leads to cardiac arrhythmia)
Endocrine abnormalities
Esophageal tears (result of vomiting)
Esophagitis (painful, swollen esophagus-result of vomiting)
Gastric dilation and rupture
Hiatal hernia
Hypoglycemia (low blood sugar)
Hair loss
Kidney damage (result of dehydration and diuretic use)
Liver damage (associated with ipecac use)
Low blood pressure
Malabsorption syndrome (small intestine becomes ineffective at absorbing vitamins and minerals)
Malnutrition
Metabolic abnormalities
Pancreatitis (inflammation of the pancreas)
Rectal burning/pain
Salivary (especially the Parotids) gland enlargement and infection

BINGE EATING DISORDER

Arthritis
Cardiac abnormalities and arrhythmia
Diabetes
Fatigue
Gastric dilation and rupture
Gastric Esophageal Reflux Disease (GERD)
Hiatal Hernia
High Cholesterol
Hypertension
Insomnia or sleep deprivation
Mobility problems
Sciatica
Sleep apnea (related to obesity)
Varicose veins

ARFID and OSFED

The medical complications associated with both ARFID and OSFED correspond to the disorders that they most resemble. In other words, complications related to ARFID mirror those of Anorexia Nervosa, while those with OSFED experience risks similar to those of the eating disorder their behaviors most closely resemble. For example, someone who is predominantly bingeing would be at risk for issues similar to those found under Binge Eating Disorder. Those who are restricting would be at risk for complications of anorexia, and those bingeing and purging would find risks similar to those with Bulimia Nervosa.