Medical Health Encyclopedia

One of the most serious effects of anorexia are 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 loss, and other problems. Low weight alone may not be sufficient to cause amenorrhea. Extreme fasting and purging behaviors may play an even stronger role in hormonal disturbance.

Psychologic Effects and Suicide

Adolescents with eating behaviors associated with anorexia (fasting, frequent exercise to lose weight, and self-induced vomiting) are at high risk for anxiety and depression in young adulthood. Some studies estimate that between 12 - 18% of people who are anorexic also abuse alcohol or drugs. Even worse, suicide has been estimated to account for as many as half the deaths in anorexia. In one study, 22% of anorexic patients attempted suicide during the course of the 8-year study period.

Heart Disease

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Heart disease is the most common medical cause of death in people with severe anorexia. 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.

Bradycardia is a slowness of the heartbeat, usually at a rate under 60 beats per minute (normal resting rate is 60 - 100 beats per minute).

• Blood flow is reduced.
• Blood pressure may drop.
• The heart muscles starve, losing size.
• Cholesterol levels tend to rise.

Click the icon to see an image of cholesterol.