Medical Complications of Eating Disorders

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Medical Complications of Eating Disorders

The following is a list of possible medical complications that accompany Eating Disorders. If left untreated the physical complications from practicing an eating disorder can become life threatening.

CARDIOVASCULAR

Slow pulse
Low blood pressure
Electrocardiogram abnormalities
Hypovolemia
Myocardiopathy and CHF (especially with use of ipecac)

CHEMISTRIES

Uric acid elevated
Cholesterol is abnormal (elevated or depressed)
Carotene is elevated
Deficiencies of trace minerals
Low blood glucose
Hypochloremic metabolic alkalosis

DENTAL AND MOUTH

Increased dental caries
Highly sensitive teeth from gingival deterioration
Pyorrhea
Lacerations and contusions of the oral cavity from use of objects to induce emesis
Tooth Loss
Erosion of enamel
Altered bite
Bleeding gums
Oral sensitivity

DERMATOLOGIC

Dry skin
Loss of subcutaneous tissues and fat in general
Scars (such as on knuckles due to inducing emesis)
Fine lanugo hair
Acrocyanosis

EFFECTS ON BRAIN AND CNS

Lack of REM sleep
Affected hypothalamus (lower body temperature, loss of shivering response, cold intolerance, and malfunction of entire temperature regulating system) due to chronic malnutrition
EEG abnormalities

ENDOCRINE

T-3 deficiency (leading to bradycardia, sluggish reflexes, dry skin, cold intolerance, hypercarotenemia, and various abnormalities of the hair)
Abnormal calcium levels and symptoms
Hypogonadism
Partial diabetes insipidus condition and the inability to concentrate urine normally
Addisons disease or hyperaldosteronism

FLUID AND ELECTROLYTE ABNORMALITIES

Effects of resultant metabolic alkalosis, potassium and chloride deficiencies
Electrolyte Imbalance
Skeletal muscle weakness
Diminished reflexes
Abnormal gastrointestinal motility
Cramps
Paresthesia
Polyuria and oliguria
Nocturia
CNS abnormalities
Constipation
Cardial effects (conduction abnormalities, irregular rhythms and sudden death)
Impaired kidney function
Emotional lability and lassitude
Potassium increase due to diuretic abuse causing cardiac abnormalities
Depletion of sodium (hyponatremia)
Dehydration
Hyponatremia
Edema

GASTROINTESTINAL

Abdominal pain, bloating, and fullness
Esophageal perforations and lacerations (Mallory-Weiss Syndrome)
Irritable bowel syndrome
Ulceration of the bowel
Malabsorption of nutrients leading to hypoproteinemia, hypoalbuminemia and calcium deficiency
Fatty infiltration of the liver
Pancreatitis
Exacerbation of hemorrhoids
Esophagitis
Melanosis coli
Gastritis
Gastric ulceration
Intestinal injury

GYNECOLOGIC

Menstrual irregularity
Amenorrhea
Infertility
Atrophic vaginitis and loss of sexual appetite
Breast atrophy

HEMATOLOGIC ABNORMALITIES

Anemia
Leukopernia
Thrombocytopenia
Bone marrow may be deficient or hypocellular

OPHTHALMOLOGIC

Transient blurred vision
Dark circles, puffiness under the eyes

ORTHOPEDIC AND MUSCULOSKELETAL

Osteoporosis
Loss of muscle mass leading to muscular weakness

PULMONARY

Aspiration pneumonia

RENAL

Prerenal and renal azotemia due to diminished renal pertusion and chronic dehydration
Tubular and collecting system abnormalities due to electrolyte abnormality
Predisposition to renal stones
Kidney failure

MISCELLANEOUS

Bacterial and fungal infections
Bilateral parotid gland swelling
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Eating disorders not only affect the disordered individual but also the person's relationships with others. Those who care the most, are often those most affected. Oftentimes, relationships with family members and friends are severely damaged as a result of the eating disorder. Communication within the family is often strained and sometimes non-existent. Feelings of anger, fear, sadness, shame, guilt and abandonment run rampant in the affected family. Family and friends are often concerned but do not know what to do. The following is a partial guideline for families and friends to assist in the recovery from an eating disorder.

It's Not Your Fault. Eating disorders are diseases and are not caused by family, friends or even the eating disordered individual themselves. There is no simple cause of eating disorders nor is there a simple cure. It is not possible to force an Anorexic to eat, prevent a Bulimic from purging, or stop a Compulsive Overeater from bingeing. Family and friends often feel they must take on responsibility for the eating disorder, which is something they truly have no control over. The guilt associated with this misplaced responsibility can become paralyzing at times. Once you, as a family member or friend, have accepted that the eating disorder is not anyone's fault, you can be freed to take action that is honest and not clouded by what you "should" or "could" have done.

Being There. Eating disorders can be viewed as a survival mechanism. Even though it may be difficult to understand, the practice of an eating disorder may give the effected individual a feeling of security. Just as an alcoholic uses alcohol to cope, a person with an eating disorder can use eating, purging or restricting to deal with their problems. Some of the underlying intra-personal issues that attribute to an eating disorder include low self-esteem, depression, feelings of loss of control, feeling worthless, identity concerns, and inability to cope with emotions. The practice of an eating disorder may be an expression of something that the eating disordered individual has found no other way of expressing. For many the practice of an eating disorder is their cry for help. You may be the one who has to initiate the conversation as often the eating disordered person feels afraid, unsafe or even that they do not deserve the help. As a family member or friend, you can help them by empathetically listening and finding out their perspective of the situation. To empathize with someone you need not agree with their perspective, but you must listen to them in a nonjudgmental way. You can listen empathetically by attempting to understand the other person's feelings through relating similar feelings you have had through related experiences. Practice active listening. In active listening, the receiver tries to understand what the sender is trying to portray. The receiver then puts what they understand the sender has said into their own words and reiterates the message back to the sender. It will be healing and comforting for the person to share her or his own perspective without feeling judged. Eating disordered individuals often feel that if they were truthful about their disease, family members and friends would abandon them. Acknowledgement, acceptance and understanding can go a long way.

Share Your Feelings. Be honest with the person and let them know how the eating disorder is effecting your life. Try speaking from your own experience and using "I" statements. Rather than stating "you're too thin" or "you're killing yourself" tell the person how you feel. "I'm scared and I feel like I'm losing you" or " I heard you throwing up in the bathroom and I'm afraid" are statements that share the feelings that you are experiencing. Avoid assigning blame, remember eating disorders are diseases and not a matter of willpower. In addition to feelings of concern, you may be experiencing feelings of anger and resentment. These are natural and can be expressed without making the eating disordered person feel abandoned. "Sometimes I get so angry and frustrated seeing you slowly kill yourself, because I'm concerned and I don't know what to do" is an example of such a statement.

More Than Their Weight. When someone you care about is losing or gaining large amounts of weight or participating in dangerous purging activities it is difficult to not focus solely on these issues. Eating disorders do have serious and potentially fatal medical consequences that should not be ignored. But concentrating only on these physical issues can leave the eating disordered individual feeling misunderstood and ignored when it comes to their emotional pain. Often, they are already obsessed with their weight, appearance and food. Any comments regarding these issues will usually be heard as negative or may possibly cause the person to feel guilt. Eating disordered individuals need to be related to in areas other then their weight and eating. Make yourself available for these intimate conversations. Concern regarding the emotional well-being of a person with an eating disorder will be paramount in their eventual recovery.

Don't Give Up. Denial of the disorder and downplaying the seriousness of their behaviors is common with eating disordered individuals. Be prepared for strong reactions from the eating disordered person. Anger, embarrassment, withdrawal and betrayal are all emotions that the eating disordered person may use to hide their true feeling of terror of losing their perceived sense of control, that the eating disorder affords them. Although, it may seem that the effort and concern you are imparting is falling on deaf ears, do not resign yourself to the eating disorder. Possibly, the eating disordered individual is just not ready to hear the message at that time but the next time they just might be ready. Also, the cumulative effect of hearing similar things from different people can help get the message through.

Find Education and Support. Do not try and handle the eating disorder on your own. Eating disorders are serious diseases that if left untreated can be deadly. Ten percent of all eating disorders lead to death. For this reason professional support is often warranted. Make an appointment to see a counselor and offer to accompany the person to the appointment. You can also recommend books and educational materials on eating disorders. Many communities offer support groups for eating disorders. Overeaters' Anonymous (OA) and the National Association of Anorexia Nervosa and Associated Disorders (ANAD) can be found in the phonebook or as links on our website. You may also want to consider getting support for yourself. Find a counselor, friend or support group where you can receive support for what you are going through. The eating disorder did not develop overnight nor will recovery take hold overnight. So remember to be patient, recovery takes time.
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