Eating Disorders - Complications of Anorexia

Complications of Anorexia

Anorexia nervosa is a very serious illness that has a wide range of effects on the body and mind. It is frequently associated with a number of other medical problems, ranging from frequent infections and general poor health to life-threatening conditions.

Psychological Effects and Substance Abuse

Adolescents with eating behaviors associated with anorexia are at high risk for anxiety and depression in young adulthood. Patients with anorexia are at risk for suicidal behavior or attempts. Alcohol and drug abuse are also common in patients with anorexia nervosa.

Hormonal Changes

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One of the most serious effects of anorexia nervosa is hormonal changes, which can have severe health consequences.

• Reproductive hormones, including estrogen and dehydroepiandrosterone (DHEA), are lower. Estrogen is important for healthy hearts and bones. DHEA, a weak male hormone, may also be important for bone health and for other functions.
• Thyroid hormones are lower.
• Stress hormones are higher.
• Growth hormones are lower. Children and adolescents with anorexia may experience retarded growth.

The result of many of these hormonal abnormalities in women is long-term, irregular or absent menstruation (amenorrhea). This can occur early on in anorexia, even before severe weight loss. Over time this causes infertility, bone density loss, and other problems.

Heart Disease

Heart disease is the most common medical cause of death in people with severe anorexia nervosa. The effects of anorexia on the heart are:

• Dangerous heart rhythms, including slow rhythms known as bradycardia, may develop. Such abnormalities can show up even in teenagers with anorexia.

• Blood flow is reduced.
• Blood pressure may drop.
• The heart muscles starve, losing size.

A primary danger to the heart is from imbalances of minerals, such as potassium, calcium, magnesium, and phosphate, which are normally dissolved in the body's fluid. The dehydration and starvation that occurs with anorexia can reduce fluid and mineral levels and produce a condition known as electrolyte imbalance. Certain electrolytes (especially calcium and potassium) are critical for maintaining the electric currents necessary for a normal heartbeat. An imbalance in these electrolytes can be very serious and even life threatening unless fluids and minerals are replaced. Heart problems are a particular risk when anorexia is compounded by bulimia and the use of ipecac, a drug that causes vomiting.