Physical Dangers and Effects of an Eating Disorder

There are many men and women suffering with all types of Eating Disorders that do not appear in any specific weight range. Those with Anorexia can be slightly overweight… while those with Compulsive Eating can be slightly underweight. Variations for all who suffer can be anywhere from extremely underweight to extremely overweight to anywhere in between. The outward appearance of anyone with an Eating Disorder does NOT dictate the amount of physical danger they are in, nor does is determine the emotional conflict they feel inside. They need not display even close to all of the below symptoms to be in danger.

Behaviors Associated with Eating Disorders

Starvation and restriction of food, calories and/or fat grams sometimes accompanied by self-induced vomiting, laxatives, diuretics and obsessive exercise with any food intake, or without food intake at all.
also see definitions of: Anorexia | Bulimia | Compulsive Overeating

Binge and Purge episodes – abnormally large intake of food followed by self-induced vomiting, intake of laxatives or diuretics, obsessive exercise and/or periods of starvation.
also see definitions of: Anorexia | Bulimia | Compulsive Overeating

Overeating. Binge Episodes – abnormally large, uncontrollable intake of food.
also see definitions of: Anorexia | Bulimia | Compulsive Overeating

ALL Eating Disorders are Dangerous

It is important to understand that even though a person may be suffering specifically with Anorexia, Bulimia or Compulsive Overeating, it is not uncommon for them to exhibit behaviors from each of the three. It is also not uncommon for one Eating Disorder to be swapped for another (Example: a person who is suffering with Anorexia switches to Bulimia; a persons suffering with Compulsive Overeating switches to Anorexia). This is why it is important to be aware of THE DANGERS BELOW, all of which are risks no matter what Eating Disorder you suffer with.


Dangers Associated with and Diseases Triggered or Caused by Eating Disorder Behaviors

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.
NutriQuest — Body of Evidence
Malnutrition Defined

Dehydration – caused by the depletion or lack of intake of fluids in the body, or by restriction of carbohydrates and fat. Restriction/Starvation, vomiting and laxative abuse are the primary causes in sufferers of Eating Disorders. Symptoms include dizziness, weakness, or darkening of urine. It can lead to kidney failure, heart failure, seizures, brain damage and death.
Dehydration Defined

Electrolyte Imbalances – electrolyte 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.
The Minerals That Make Up Electrolytes

Hyponatremia (related to “water-loading”) – as stated above, electrolytes are essential to proper body functioning. Drinking too much water (more than eight, eight-ounce glasses in less than twelve hours), can cause Hyponatremia (not enough sodium in the blood), especially in someone already malnourished or dehydrated. Hyponatremia can cause fluid in the lungs, the brain to swell, nausea, vomiting, confusion and even death.

Refeeding Syndrome (related to treatment) – Starved or severely malnourished patients can undergo life-threatening fluid and electrolyte shifts following the initiation of aggressive nutritional support therapies. This phenomenon is known as “refeeding syndrome” and can occur in patients receiving either enteral (tube feeding) or parenteral (intravenous feeding) nutritional support. To avoid the development of the refeeding syndrome, nutrition support in patients at risk should be increased slowly while assuring adequate amounts of vitamins and minerals. Organ function, fluid balance and serum electrolytes (especially phosphorus, potassium and magnesium) need to be monitored daily during the first week and less often thereafter.
Refeeding Syndrome
Monitoring Nutrition Therapy

Vitamin and Mineral Deficiencies

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.

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).

Muscle Atrophy – wasting away of muscle and decrease in muscle mass due to the body feeding off of itself.
Impaired Neuromuscular Function – due to vitamin and mineral deficiencies (specifically potassium), and malnutrition.
Muscle Atrophy Defined

Paralysis – transient (or temporary) paralysis — extreme weakness of muscles or not being able to move at all — Caused by low levels of potassium, and/or the degeneration of nerve cells, in the spinal cord or in the brain, which have been deprived of essential nutrients. Left untreated, periods of paralysis may happen more frequently and more severely, lead to permanent muscle weakness, and even result in death.

Tearing of Esophagus – caused by self-induced vomiting
Mallory-Weiss tear – associate with vomiting, a tear of the gastroesophageal junction
Gastric Rupture – spontaneous stomach erosion, perforation or rupture.
Gastrointestinal Bleeding – bleeding into the digestive tract.
Gastrointestinal Bleeding Information

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.
Reflux can sometimes become severe enough that food cannot be kept down at all and medical attention should be sought immediately.
Barrett’s Esophagus – associated with Cancer of the esophagus and caused by Esophageal Reflux, this is a change in the cells within the esophagus.
Gastroesophageal Reflux Disease
Barrett’s esophagus

Cancer – of the throat and voice box (Larynx) due to acid reflux disorders.
Cancer of the Larynx

Insomnia – having problems falling and/or staying asleep.
Chronic Fatigue Syndrome – continuous and crippling fatigue related to a weakened immune system.
The CFIDS Association
Hyperactivity – manic bouts of not being able to sit still.

Swelling – in face and cheeks (following self-induced vomiting).

Callused or bruised fingers – this is caused by repeatedly using the fingers to induce vomiting.

Dry Skin and Hair, Brittle Hair and Nails, Hair Loss – cause by Vitamin and Mineral deficiencies, malnutrition and dehydration.

Low Blood Pressure, Hypotension (more common in those with Anorexia and/or Bulimia) – cause by lowered body temperature, malnutrition and dehydration. Can cause heart arrhythmias, shock or myocardial infarction.

Low Blood Pressure
Orthostatic Hypotension – sudden drop in blood pressure upon sitting up or standing. Symptoms include dizziness, blurred vision, passing out, heart pounding and headaches.
Orthostatic Hypotension

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.

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.

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.
Reactive Hypoglycemia Homepage
Elevated Blood Sugar/Hyperglycemia – can lead to diabetes, liver and kidney shut down, circulatory and immune system problems.

Diabetes – high blood sugar as a result of low production of insulin. This can be caused by hormonal imbalances, hyperglycemia, or chronic pancreatitis.
Eating Disorders and Diabetes

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.

Diabetic ketoacidosis
Alcohol Ketoacidosis
*You do not need to be diabetic or alcoholic to end up with Ketoacidosis!

Iron Deficiency, Anemia – this makes the oxygen transporting units within the blood useless and can lead to fatigue, shortness of breath, increased infections, and heart palpitations.

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 of and associated with kidney infection thus making permanent kidney damage and kidney failure more likely.

Osteoporosis – Thinning of the bones with reduction in bone mass due to depletion of calcium and bone protein, predisposing to fractures.
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.

Arthritis (degenerative) – can be caused by hormonal imbalances and vitamin deficiencies as well as increased stress on the joints in individuals who suffering Compulsive Overeating.

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.
Toothaches and TMJ Syndrome
The TMJ Association

Amenorrhea – Loss of Menstrual Cycle (due to lack of secreting hormone, Oestrogen, by the ovaries). Loss of the menstrual cycle can also lead to Osteopenia and Osteoporosis.
Secondary Amenorrhea

Easily Bruising Skin – Vitamin Deficiencies that decrease the body’s ability to heal itself, low blood pressure, low platelets count and/or extreme weight loss will all lead to easily bruised skin that can take a long time to heal.

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.
Toothaches and TMJ Syndrome
Dental Erosion

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 pain killers) 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.

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, electrolyte imbalances, and hormonal imbalances 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.

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.
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.
International Council on Infertility

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).
Eating Disorders and Pregnancy

Depression – mood swings and depression can be cause 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 sufferer 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
Also see: Associations and Addictions

Lowered body temperature – Temperature Sensitivity – caused by loss of healthy insulating layer of fat and lowered blood pressure.

Cramps, bloating, constipation, diarrhea, incontinence – increased or decreased bowel activity.
Also see: dangerous methods

Peptic Ulcers – aggravated or made more severe by increased stomach acids, cigarette smoking, high consumption of caffeine or alcohol
Peptic Ulcer Info

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.

Digestive Difficulties – a deficiency in digestive enzymes will lead to the bodies inability to properly digest food and absorb nutrients. This can lead to malabsorption problems, malnutrition and electrolyte imbalances. Diseases that may be triggered by a history of an Eating Disorder include: Celiac Disease (gluten sensitivity), and Crohn’s Disease
The Connection
Gastrointestinal Disorder

Weakness and Fatigue – caused by generalized poor eating habits, electrolyte imbalances, vitamin and mineral deficiencies, depression, malnutrition, heart problems.

Seizures – the increased risk of seizures in Anorexic and Bulimic individuals may be caused by dehydration, hyperglycemia or ketoacidosis. 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. SOME type of antidepressants can increase the risk of seizure and usually carry a warning against prescribing them to people with Eating Disorders, unless the benefits significantly outweigh the risks.
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.
In Loving Memory

Please Also See Signs and Symptoms

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