Medical and psychological complications of eating disorders- ANRED


Medical problems
If not stopped, starving, stuffing, and purging can lead to irreversible physical damage and even death. Eating disorders can affect every cell, tissue, and organ in the body. The following is a partial list of the medical dangers associated with anorexia nervosa, bulimia, and binge eating disorder.

  • Irregular heartbeat, cardiac arrest, death
  • Kidney damage, renal failure, death
  • Liver damage (made worse by substance abuse), death
  • Loss of muscle mass. Broomstick arms and legs.
  • Permanent loss of bone mass; fractures and lifelong problems caused by fragile bones and joints. Osteopenia, osteoporosis, and dowager's hump
  • Destruction of teeth, rupture of esophagus, damage to lining of stomach; gastritis, gastric distress including bloat and distension
  • Disruption of menstrual cycle, infertility (see below)
  • Delayed growth and permanently stunted growth due to undernutrition. Even after recovery and weight restoration, person may not catch up to expected normal height.
  • Weakened immune system
  • Icy hands and feet
  • Swollen glands in neck; stones in salivary duct, "chipmunk cheeks."
  • Excess hair on face, arms, and body. Long, downy lanugo hair. May be emaciated body's attempt to be warm.
  • Dry, blotchy skin that has an unhealthy gray or yellow cast
  • Anemia, malnutrition. Disruption of body's fluid/mineral balance (electrolyte imbalance, loss of potassium; can be fatal)
  • Fainting spells, seizures, sleep disruption, bad dreams, mental fuzziness
  • Low blood sugar (hypoglycemia), including shakiness, anxiety, restlessness, and a pervasive itchy sensation all over the body.
  • Anal and bladder incontinence, urinary tract infections, vaginal prolapse, and other problems related to weak and damaged pelvic floor muscles. Some problems may be related to chronic constipation, which is commonly found in people with anorexia nervosa. Structural damage and atrophy of pelvic floor muscles can be caused by low estrogen levens, excessive exercise, and inadequate nutrition. Surgery may be necessary to repair the damage.
  • Because of changes in the brain associated with under-nourishment, binge eating, and purging, the person does not, and perhaps cannot, weigh priorities, make judgments, and make choices that are logical and rational for normal people. Recovery, once the process has begun, requires time for the brain to readjust -- chemically and physically -- to normal and healthy patterns of eating. This is a combined physical/psychological problem.


If binge eating disorder leads to obesity, add the following:
  • Increased risk of cardiovascular disease
  • Increased risk of bowel, breast, and reproductive cancers
  • Increased risk of diabetes
  • Arthritic damage to joints


Dieting risk
  • In one study, researchers asked women to reduce their caloric intake by 50%. After 15 weeks, the activity of their natural killer cells (a part of the immune system that combats viruses) fell 20%. (Health magazine, 1999)


The curse of washboard abs: women with well-defined belly muscles
  • Women with well-defined belly muscles may have as little as six percent body fat. The healthy range is 15-23 percent. Menses stop when fat falls below ten percent. The associated low levels of estrogen can lead to osteoporosis, even in 20-year-olds. Is a rippling stomach worth a dowager's hump? (Lew Lyon, exercise physiologist. Reported in Newsweek, May 5, 1997)



Psychological problems
As painful as the medical consequences of an eating disorder are, the psychological agony can be worse. It is a sad irony that the person who develops an eating disorder often begins with a diet, believing that weight loss will lead to improved self-esteem, self-confidence, and happiness. The cruel reality is that persistent undereating, binge eating, and purging have the opposite effect. Eating disordered individuals typically struggle with one or more of the following complications:

  • Depression that can lead to self-harm and suicide
  • Person feels out of control and helpless to do anything about problems
  • Anxiety, self-doubt
  • Guilt and shame, feelings of failure
  • Hypervigilance. Thinks other people are watching and waiting to confront or interfere.
  • Fear of discovery
  • Obsessive thoughts and preoccupations
  • Compulsive behaviors. Rituals dictate most activities.
  • Feelings of alienation and loneliness. "I don't fit in anywhere."
  • Feels hopeless and helpless. Cannot figure out how to make things better. May give up and sink into despair, fatalism, or suicidal depression.
  • Because of changes in the brain associated with under-nourishment, binge eating, and purging, the person does not, and perhaps cannot, weigh priorities, make judgments, and make choices that are logical and rational for normal people. Recovery, once the process is begun, requires time for the brain to readjust -- chemically and physically -- to normal and healthy patterns of eating. This is a combined physical/psychological problem.



Related problems
Eating disorders bring pain and suffering not only to the people who have them but also to their families, friends, and romantic partners. Coworkers and even casual acquaintances can be affected too. These problems include the following:

  • Disruption of family. Blame, fights over food, weight, treatment, and so forth.
  • Family members struggle with guilt, worry, anxiety, and frustration. Nothing they do seems to make things better.
  • Friendships and romantic relationships are damaged or destroyed. Person with the eating disorder is, or becomes, emotionally cool and withdrawn, crabby and cranky, minimally or not at all interested in sex, and secretive and controlling, often in a passive/aggressive manner.
  • If person binges and purges while driving (yes, some people do that), auto accidents may be the result of distraction.
  • If person is a student or athlete, teachers, coaches, and trainers may experience the same worry and frustration that plagues family members.



A note about exercise-induced disruption of menstrual periods and infertility
Women with reproductive problems related to excessive exercise may be able to correct those problems by eating more calories. A 2001 study at University of Pittsburgh looked at whether amenorrhea and infertility are caused by exercise stress or expenditure of high levels of energy. "The findings show that it is [lack of] energy consumption during exercise that causes reproductive dysfunction," said Dr. Judy Cameron, one of the researchers. When the study created exercise conditions for monkeys that approximated human marathon training, the animals experienced reproductive impairments. When they were given more to eat, those impairments disappeared. It is logical to think the results in humans would be the same.


Important: Eating disorders are treatable, and people do recover from them. The above complications, or the threat of them, should encourage you to seek treatment, not give up and sink into despair. Sooner is better than later. The sooner you begin treatment, the sooner you can develop personal strength and begin to create a life worth living.

Please Note: ANRED information is not a substitute for medical or psychological evaluation and treatment. For help with the physical and emotional problems associated with eating disorders, talk to your physician and a mental health professional.