Health Consequences of Eating Disorders

Eating disorders are serious, potentially life-threatening conditions that affect a person’s emotional and physical health. They are not just a “fad” or a “phase.” They are real, complex, and devastating conditions that can have serious consequences for health, productivity, and relationships. 

In anorexia nervosa’s cycle of self-starvation, the body is denied the essential nutrients it needs to function normally. Thus, the body is forced to slow down all of its processes to conserve energy, resulting in serious medical consequences:

• Abnormally slow heart rate and low blood pressure, which mean that the heart muscle is changing. The risk for heart failure rises as the heart rate and blood pressure levels sink lower and lower.
• Reduction of bone density (osteoporosis), which results in dry, brittle bones.
• Muscle loss and weakness.
• Severe dehydration, which can result in kidney failure.
• Fainting, fatigue, and overall weakness.
• Dry hair and skin; hair loss is common.
• Growth of a downy layer of hair called lanugo all over the body, including the face, in an effort to keep the body warm.

The recurrent binge-and-purge cycles of bulimia can affect the entire digestive system and can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions. Some of the health consequences of bulimia nervosa include:

• Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death. Electrolyte imbalance is caused by dehydration and loss of potassium, sodium and chloride from the body as a result of purging behaviors.
• Potential for gastric rupture during periods of bingeing.
• Inflammation and possible rupture of the esophagus from frequent vomiting.
• Tooth decay and staining from stomach acids released during frequent vomiting.
• Chronic irregular bowel movements and constipation as a result of laxative abuse.
• Peptic ulcers and pancreatitis.

Binge eating disorder often results in many of the same health risks associated with clinical obesity. Some of the potential health consequences of binge eating disorder include:

• High blood pressure.
• High cholesterol levels.
• Heart disease as a result of elevated triglyceride levels.
• Type II diabetes mellitus.
• Gallbladder disease.

All eating disorders are associated with increased risk of mortality, including death caused by the eating disorder behaviors themselves, substance abuse or suicide, and death from general causes such as cancer, likely because eating disorders impact the immune system. Anorexia has the highest mortality rate of any mental health condition.

 

All of these risks are scary, but treatment is available and recovery is possible. If you or someone you know has an eating disorder, reach out to find help. One option is the NEDA helpline at (800) 931-2237.

 

 

What is "Normal" Eating?

It's hard to be a part of our culture without adopting some disordered eating beliefs, attitudes, and/or behaviors. Half of the commercials on television promote diet or weight loss products. TV shows such as "The Biggest Loser" portray hard-core dieting. Even the "news media" spends a good chunk of time on diet, and whatever the newest diet fad may be. And all of this attention is driven primarily by dollars.

Why is this kind of information so profitable? Not because it's good for us, but because, as a culture, we have become chronically dissatisfied with our bodies. We have an unrealistic ideal about what the body should look like, and believe (in part because of what we see on TV) that we could get our bodies to look like that if we just follow a magic diet and exercise plan. The magic solution changes over time, of course, because it's never quite magic enough.

The result is that many or most people are very misinformed when it comes to what it means to eat "normally." Carbohydrates, for example, have received a bad rap over the last decade. However, carbohydrates are crucial to the body, and particularly to the brain. They are the body's main energy source, and the only type of energy the brain can use. 45-65% of one's diet should be made up of carbohydrates.

Dietary fats are also much maligned, based on the simplistic notion that fat in the diet becomes fat on the body. That's just not true. It happens to have the same word, but that doesn't make it the same thing! Dietary fats are important for many things. They keep us from getting hungry again too quickly, because they get digested more slowly than carbohydrates. They help us absorb fat-soluble vitamins, and help to protect our internal organs. They are a vital ingredient for healthy hair, skin, and nails. They also help produce the myelon sheathes on our nerve cells, allowing our brain to send messages efficiently.

So much for low-fat, low-carb diets! If that's not the answer, what is "normal eating?" The best answer to this question that I have ever come across is that offered by Ellyn Satter:

Normal eating is going to the table hungry and eating until you are satisfied. It is being able to choose food you like and eat it and truly get enough of it -not just stop eating because you think you should. Normal eating is being able to give some thought to your food selection so you get nutritious food, but not being so wary and restrictive that you miss out on enjoyable food. Normal eating is giving yourself permission to eat sometimes because you are happy, sad or bored, or just because it feels good. Normal eating is mostly three meals a day, or four or five, or it can be choosing to munch along the way. It is leaving some cookies on the plate because you know you can have some again tomorrow, or it is eating more now because they taste so wonderful. Normal eating is overeating at times, feeling stuffed and uncomfortable. And it can be undereating at times and wishing you had more. Normal eating is trusting your body to make up for your mistakes in eating. Normal eating takes up some of your time and attention, but keeps its place as only one important area of your life.

In short, normal eating is flexible. It varies in response to your hunger, your schedule, your proximity to food and your feelings.

For more about eating competence (and for research backing up this advice), see Ellyn Satter's Secrets of Feeding a Healthy Family: How to Eat, How to Raise Good Eaters, How to Cook, Kelcy Press, 2008. Also see www.EllynSatter.com to purchase books and to review other resources.

Copyright © 2012 by Ellyn Satter. Published at www.EllynSatter.com.

Eating Disorders are Equal Opportunity Employers

One of my clients went to see a cardiologist to make sure his heart had not been affected by his eating disorder. The tech asked why he was there, and when he told her, she laughed and said that "boys don't get eating disorders." He went home and restricted.

Many people have the stereotype that eating disorders are something that young, White women get. While it may be true that many individuals who have eating disorders fit this stereotype, there are also many who do not. Boys and men get eating disorders. People of all races and ages get eating disorders. But people who don't fit the stereotype may decide not to seek treatment out of fear that they will be judged, or their suffering will be dismissed, simply because they don't fit with people's assumptions.

We need to break down these stereotypes so that everyone can get help and support. Eating disorders are equal opportunity employers (and yes, I think "employer" fits because a central feature of eating disorders is that they are demanding task masters).

Mirrorless Monday

When you look in the mirror, do you like what you see? Do you notice the good aspects of your appearance, or do you hone in on whatever you don't like about your looks? Many people can pass a mirror or glance at their reflection and think nothing of it. Some people can't.

Some people get trapped in mirrors. They fall in. They catch sight of some perceived flaw or defect, and stare at it, as it seems to grow and morph in front of them. It may be a blemish or a bad hair day. It may be facial features, or body shape, weight and fat, lumps and bumps we all have. These imperfections become all-consuming.

For others, mirrors become more animated. Mirrors taunt them, call them names, belittle them. They can hardly stand to glance at themselves, and may avoid their reflection altogether to escape the bullying. Unfortunately, the bully lives in their own heads.

For people with eating disorders, mirrors are triggers. Some try to mask what they see as unattractive (often, what they see as "fat"), engaging in obsessive appearance checking and fixing. Others go out of their way to avoid having to see themselves. Neither strategy helps to correct the misperceptions, or allows people to see their own beauty.

Therefore, for eating disorder awareness week (and anytime, really), take a stand by participating in "Mirrorless Monday." Cover your mirrors with paper - any kind will do - and write affirmations of inner beauty for yourself, your partner, your kids, or others around you.

Remember, mirrors do not define us. They don't even give us that accurate a view of ourselves. Let's not let them dominate us!

Eating Disorders Awareness

Today is the beginning of Eating Disorders Awareness Week, and this year's theme is "Everybody knows Somebody" (with an eating disorder). The purpose of the campaign is to reduce stigma and stereotypes that so often stand in the way of people getting the help they need. As an eating disorders specialist, I'll be participating through a series of blog posts over the course of the week. You are not alone!