Medical Complications of Eating Disorders

Living Room at Oceanaire

Many women struggle with some sort of disordered eating. Statistics suggest:

1 in 200 American women suffers from anorexia
2 - 3 in 100 American women suffers from bulimia
Nearly half of all Americans personally know someone with an eating disorder
Only 1 in 10 people with eating disorders receive treatment

Source: Body Wars: Making Peace with Women’s Bodies, by Margo Maine, Ph.D., Gürze Books, 2000

For the most part, women who struggle with disordered eating and body image will not develop an eating disorder. However, it is estimated between 1 - 5% of the population suffer. Estimates suggest that more than eight million people will develop an eating disorder; seven million women and one million men. It has also been found that certain temperaments are prevalent in someone who is more susceptible to an eating disorder. Some of these temperaments may include depression, obsessive-compulsive behaviors, anxiety issues, perfectionism, as well as sleep disturbances.

Below is a list of medical complications associated with eating disorders:

Amenorrhea - Loss of menstrual cycle (due to lack of secreting hormone, Estrogen, by the ovaries). Loss of the menstrual cycle can also lead to Osteopenia and Osteoporosis.
Anemia - this makes the oxygen transporting units within the blood useless and can lead to fatigue, shortness of breath, increased infections, and heart palpitations.
Bad Circulation, Slowed or Irregular Heartbeat, Arrhythmias, Angina, Heart Attack - There are many factors associated with having an Eating Disorder that can lead to heart problems or a heart attack. Sudden cardiac arrest can cause permanent damage to the heart, or instant death... electrolyte imbalances (especially potassium deficiency), dehydration, malnutrition, low blood pressure, extreme orthostatic hypotension, abnormally slow heart rate can all cause serious problems with the heart. High blood pressure, accumulation of fat deposits around the heart muscle, high cholesterol, decreased exercise due to lack of mobility, diabetes and hormonal imbalances can all lead to serious problems with the heart as well.
Arthritis (degenerative) - can be caused by hormonal imbalances and vitamin deficiencies as well as increased stress on the joints in individuals who are suffering Compulsive Overeating.
Barrett's Esophagus - associated with Cancer of the esophagus and caused by Esophageal Reflux, this is a change in the cells within the esophagus.
Callused or bruised fingers - this is caused by repeatedly using the fingers to induce vomiting.
Cancer - of the throat and voice box (Larynx) due to acid reflux disorders.
Chronic Fatigue - continuous and crippling fatigue related to a weakened immune system.
Cramps, bloating, constipation, diarrhea, incontinence - increased or decreased bowel activity.
Dehydration - caused by the depletion or lack of intake of fluids in the body. Restriction/Starvation, vomiting and laxative abuse are the primary causes in victims of Eating Disorders. Symptoms include dizziness, weakness, or darkening of urine. It can lead to kidney failure, heart failure and death.
Dental Problems, Decalcification of teeth, erosion of tooth enamel, severe decay, Gum Disease - will be caused by stomach acids and enzymes (from vomiting); vitamin D and calcium deficiencies, and hormonal imbalance. Can also be due to the lack of exercise the teeth can get from the process of eating certain foods. Dental problems can sometime indicate problems with the heart.
Depression - mood swings and depressions can all be caused by physiological factors such as electrolyte imbalances, hormone and vitamin deficiencies, malnutrition and dehydration. Living with the Eating Disorder behaviors themselves will cause depression. Depression can also lead the victim back into the cycle of the Eating Disorder (or may have initially been the problem before the onset of the ED). Stress within family, job and relationships can all be causes. There are also a percentage of people born with a pre-disposition to depression, based on family history. Can lead to Suicide.
Diabetes - high blood sugar as a result of low production of insulin. This can be caused by hormonal imbalances, hyperglycemia, or chronic pancreatitis.
Digestive Difficulties - a deficiency in digestive enzymes will lead to the body's inability to properly digest food and absorb nutrients. This can lead to malabsorption problems, malnutrition and electrolyte imbalances.
Disruptions in Blood Sugar Levels - Low Blood Sugar/Hypoglycemia: can indicate problems with the liver or kidneys and can lead to neurological and mental deterioration. Elevated Blood Sugar/Hyperglycemia - can lead to diabetes, liver and kidney shut down, circulatory and immune system problems.
Dry Skin and Hair, Brittle Hair and Nails, Hair Loss - caused by vitamin and mineral deficiencies, malnutrition and dehydration.
Easily Bruising Skin - Vitamin Deficiencies that decrease the body's ability to heal itself, low blood pressure and extreme weight loss can all lead to easily bruised skin that can take a long time to heal.
Edema - swelling of the soft tissues as a result of excess water accumulation. It is most common in the legs and feet of Compulsive Overeaters and in the abdominal area of Anorexics and/or Bulimics (can be caused by Laxative and Diuretic use).
Electrolyte Imbalances - electrolytes are essential to the production of the body's "natural electricity" that ensures healthy teeth, joints and bones, nerve and muscle impulses, kidneys and heart, blood sugar levels and the delivery of oxygen to the cells.
Esophageal Reflux - Acid Reflux Disorders - partially digested items in the stomach, mixed with acid and enzymes, regurgitates back into the esophagus. This can lead to damage to the esophagus, larynx and lungs and increases the chances of developing cancer of the esophagus and voice box.
Gastric Rupture - spontaneous stomach erosion, perforation or rupture.
High Blood Pressure, Hypertension (more common in those with Compulsive Overeating and/or Binge Eating Disorder) - elevated blood pressure exceeding 140 over 90. Can cause: blood vessel changes in the back of the eye creating vision impairment; abnormal thickening of the heart muscle; kidney failure; and brain damage.
Hyperactivity - manic bouts of not being able to sit still.
Impaired Neuromuscular Function - due to vitamin and mineral deficiencies (specifically potassium), and malnutrition.
Infertility - the inability to have children. Caused by loss of menstrual cycle, and hormonal imbalances. Malnutrition and vitamin deficiencies can also make it impossible to succeed with a full-term pregnancy, and can increase the chances significantly of a baby born with birth defects.
Insomnia - having problems falling and/or staying asleep.
Ketoacidosis - high levels of acids that build up in the blood (known as ketones) caused by the body burning fat (instead of sugar and carbohydrates) to get energy. It can be a result of starvation, excessive purging, dehydration, hyperglycemia and/or alcohol abuse (it can also be a result of uncontrolled or untreated diabetes). It can lead to coma and death.
Kidney Infection and Failure - your kidneys "clean" the poisons from your body, regulate acid concentration and maintain water balance. Vitamin deficiencies, dehydration, infection and low blood pressure increase the risks and are associated with kidney infection thus making permanent kidney damage and kidney failure more likely.
Lanugo - (soft downy hair on face, back and arms). This is caused due to a protective mechanism built-in to the body to help keep a person warm during periods of starvation and malnutrition, and the hormonal imbalances that result.
Liver Failure - the liver aids in removing waste from cells, and aids in digestion. You cannot live without your Liver. Fasting and taking acetaminophen (drug found in over-the-counter painkillers) increases your risks for Liver damage and failure. Loss of menstruation and dehydration (putting women at risk for too much iron in their system), and chronic heart failure can lead to liver damage or failure.
Low Blood Pressure, Hypotension (more common in those with Anorexia and/or Bulimia) - caused by lowered body temperature, malnutrition and dehydration. Can cause heart arrythmias, shock or myocardial infarction.
Orthostatic Hypotension - sudden drop in blood pressure upon sitting up or standing. Symptoms include dizziness, blurred vision, passing out, heart pounding and headaches.
Low Platelet Count or Thrombocytopenia - Caused by low levels of vitamin B12 and Folic Acid, and/or by excessive alcohol. It may also be an indication of a suppressed immune system or immune dysfunction.
Lowered body temperature - Temperature Sensitivity - caused by loss of healthy insulating layer of fat and lowered blood pressure.
Mallory-Weiss tear - associated with vomiting, a tear of the gastroesophageal junction.
Malnutrition - caused by undereating or overeating. The word malnutrition indicates deficiency for energy, protein and micronutrients (e.g. vitamin A, iodine and iron) either singularly or in combination. It can cause severe health risks including (but not limited to) respiratory infections, kidney failure, blindness, heart attack and death.
Muscle Atrophy - wasting away of muscle and decrease in muscle mass due to the body feeding off of itself.
Osteopenia - Below normal bone mass indicating a calcium and/or vitamin D deficiency and leading to Osteoporosis.* Hormone imbalance/deficiencies associated with the loss of the menstrual cycle can also increase your risks of Osteoporosis and Osteopenia.
Osteoporosis - Thinning of the bones with reduction in bone mass due to depletion of calcium and bone protein, predisposing to fractures.
Pancreatitis - this is when the digestive enzymes attack the pancreas. It can be caused by repeated stomach trauma (such as with vomiting), alcohol consumption or the excessive use of laxatives or diet pills.
Peptic Ulcers - caused by increased stomach acids, cigarette smoking, high consumption of caffeine or alcohol.
Polycystic Ovarian Syndrome - a study a few years ago suggested that people with Eating Disorders were at an increased risk for developing Polycystic Ovarian Syndrome (PCO), and that recovery from the Eating Disorder should be part of treatment for PCO
Problems during pregnancy - including potential for high-risk pregnancies, miscarriage, still born babies and death or chronic illness from minor to severe, in children born (all due to malnutrition, dehydration, vitamin and hormone deficiencies).
Reflux - can sometimes become severe enough that food cannot be kept down at all and medical attention should be sought immediately.
Seizures - the increased risk of seizures in Anorexic and Bulimic individuals may be caused by dehydration. It is also possible that lesions on the brain caused by long-term malnutrition and lack of oxygen-carrying cells to the brain may play a role.
Swelling - in face and cheeks (following self-induced vomiting).
Tearing of Esophagus - caused by self-induced vomiting.
TMJ "Syndrome" and Related TMJ Problems - degenerative arthritis within the tempero-mandibular joint in the jaw (where the lower jaw hinges to the skull) creating pain in the joint area, headaches, and problems chewing and opening/closing the mouth. Vitamin deficiencies and teeth grinding (often related to stress) can both be causes.
Weakness and Fatigue - caused by generalized poor eating habits, electrolyte imbalances, vitamin and mineral deficiencies, depression, malnutrition, and heart problems.
Death - caused by any of the following or any combination of the following: heart attack or heart failure; lung collapse; internal bleeding, stroke, kidney failure, liver failure; pancreatitis, gastric rupture, perforated ulcer, depression and suicide.

(*Thank you to www.something-fishy.org for this expansive list.)