Nutrition For Eating Disorders: Risks And Recovery

Medically reviewed by Andrea Brant, LMHC
Updated November 4, 2024by BetterHelp Editorial Team

Eating disorders can pose a variety of risks to interpersonal functioning and mental well-being, but they can have damaging physical effects as a result of their disruption to nutritional health as well. Some of these types of conditions can lead to severe shortages of food energy and key nutrients, while others may eventually lead to problems like obesity and diabetes. 

Seeking professional support is recommended for those experiencing signs of an eating disorder, as working with a registered dietitian and a licensed therapist may help affected individuals recover. Some patients may also need substantial medical oversight to avoid dangerous medical complications related to nutrition. Learn more about nutrition as it relates to eating disorders below.

A female nurse in blue scrubs sits at her computer deck with her lpatop as she gazes off deep in thought.
Getty/blackCAT
Get support for eating disorder symptoms

Food restriction in eating disorders

Several kinds of eating disorders involve symptoms related to severe self-imposed limitations on food consumption. Examples of such disorders include:

  • Anorexia nervosa: This well-known eating disorder is characterized by deliberate avoidance or restriction of food consumption out of a compulsive desire for thinness and weight loss. This restriction is sometimes exacerbated by excessive exercise or purging behaviors like self-induced vomiting or inappropriate use of laxatives.
  • Bulimia nervosa: Bulimia is characterized by binge eating episodes followed by purging. People with this condition may also engage in significant dietary restriction between episodes.
  • Avoidant/restrictive food intake disorder (ARFID): People with ARFID eat only very particular foods or only very small portions. Unlike those with anorexia, their behaviors are due to sensory discomfort or fears of choking or vomiting rather than concerns about body image. 
  • Other specified feeding and eating disorder (OSFED): This diagnostic category may be used to describe patients whose symptoms don’t precisely fit other eating disorder criteria, but who may exhibit a range of disordered eating behaviors such as extreme food restriction and purging. 
Conditions involving food restriction may have some of the most severe medical consequences of any eating disorder. Anorexia has a higher mortality rate than any other psychological illness, and even people who survive may experience wide-ranging health consequences. That’s why early intervention is considered to be crucial for improving long-term outcomes.

Nutritional impacts of anorexia nervosa and other restrictive eating disorders

Because conditions like anorexia typically involve eating significantly less food than the body needs to function, they may result in a variety of nutritional abnormalities. For example, a 2017 study indicates that people living with these disorders may exhibit deficiencies in vital nutrients such as:

  • Folate: Also known as vitamin B9, folate is needed to produce DNA and blood cells. 
  • Vitamin B12: Another “B” vitamin, B12 plays an important role in blood production as well as gastrointestinal and neurological health.
  • Magnesium: This mineral is used for multiple critical functions in human cells, such as the synthesis of DNA and the energy transport molecule ATP.
  • Manganese: Manganese is used in a variety of enzymes, and its absence is associated with skeletal weakness and poor wound healing.
  • Zinc: This mineral plays a role in many biological systems, including the immune and nervous systems.
  • Calcium: Calcium is a crucial element for nerve signaling and bone health.
  • Potassium: Like calcium, potassium is necessary for nerve transmission as well as other functions including gastrointestinal mobility, electrolyte balance, and production of glucose and insulin.
  • Sodium: This nutrient is necessary for the regulation of blood pressure and pH.
  • Phosphate: The body’s cell membranes, energy storage molecules, DNA, bones, and teeth all require phosphate.
  • Vitamin D: This vitamin is crucial for absorbing and regulating several other nutrients and has important functions in the immune system.

In addition to shortages of individual nutrients, people with eating disorders frequently display overall caloric restriction, or taking in less food energy than the body requires. One study from 2023 found that the average level of caloric restriction in inpatients with restrictive eating disorders was over 50%, meaning that those affected were regularly consuming less than half the energy they needed for healthy bodily functioning. 

Health effects of anorexia nervosa and other restrictive eating disorders

The nutritional deficits described above can lead to a broad array of medical complications affecting nearly every part of the body. That’s why getting treatment for signs of anorexia as soon as possible can be paramount for health and even survival. Just some of many examples of potential health consequences of anorexia include things like:

  • Weakness, dizziness, and fatigue
  • Brittle hair, nails, and bones
  • Shortness of breath
  • Difficulty regulating body temperature
  • Gastrointestinal difficulties
  • Cardiovascular problems
  • Brain atrophy and cognitive impairment (confusion, difficulty concentrating, etc.)
  • Severe organ dysfunction and death
A female therapist points out some information in a book that her female patient is holding in her hands.
Getty/Valeriy_G

Binge eating disorder

Although most people associate eating disorders with caloric restriction, binge eating disorder is the most common eating disorder in the United States. This condition involves repeated episodes of compulsive, excessive eating, often accompanied by feelings of shame and helplessness. Unlike bulimia or the binge-purge subtype of anorexia, binge eating disorder does not involve compensatory attempts to prevent weight gain such as fasting, exercising, or purging.

Binge eating behavior also occurs in bulimia and some forms of anorexia. While affected individuals may try to “cancel it out” with purging behavior, this is often an ineffective weight loss strategy (in addition to its other negative health effects). The binge/purge cycle may also still result in patients consuming more food than they need overall. Binge eating disorder, anorexia, and bulimia are all serious and potentially dangerous conditions that require professional treatment.

Nutritional impacts of binge eating 

Because binge eating involves repeatedly consuming excessive amounts of food, it can disrupt dietary health in several ways. The most common impact is unhealthy weight gain and a higher risk of obesity.

In addition, binge eating may trigger frequent spikes in blood sugar, which can have a variety of metabolic consequences. Insulin resistance, which can result from a persistently high glycemic index, is commonly associated with binge eating disorder

Binge episodes also commonly involve excessive consumption of foods that feel satisfying but have poor nutritional value, such as sweets or salty snacks. This can lead to unhealthy excesses of certain nutrients, such as high sodium levels. At the same time, other important nutrients may be lacking in a person’s eating patterns.

Health effects of binge eating disorder

When binge eating leads to excess weight gain or obesity, it can place affected individuals at significantly higher risk for many different medical complications, including:

  • Heart disease
  • Sleep apnea
  • Asthma
  • Gallbladder dysfunction
  • Poor joint health
  • Depression
  • Some forms of cancer

Elevated blood sugar and insulin resistance due to frequent binge episodes can also result in metabolic syndrome and type 2 diabetes. These conditions can have serious health impacts and have the potential to be fatal. 

How nutritional problems can reinforce eating disorder symptoms

Along with the many other potential consequences of nutritional imbalances, they may also make it more difficult for an individual to recover from disordered eating behavior. Poor nutrition can have several counterproductive effects on the way the brain and body respond to food, such as the following.

Lack of appetite-related nutrients

Some of the nutrients commonly lacking in people with anorexia, such as thiamin and folate, play an important role in functions like eating and digestion. Deficiencies in these substances may diminish a patient’s appetite or cause gastrointestinal malfunctions that make healthy eating difficult.

Disruption of brain circuitry

Malnutrition in anorexia appears to decrease functional connectivity in various regions of the frontal and temporal lobes, some of which relate to functions like behavior control, taste perception, visual processing, fear, and anxiety. This effect may strengthen factors that contribute to eating disorder behavior, such as a distorted body image or an exaggerated fear of weight gain. 

Hormonal changes

Calorie restriction can elevate levels of cortisol, a hormone that may suppress the desire to eat and speed up metabolism. This could increase the challenges with weight restoration in individuals with restrictive eating disorders.

Mental health effects

Obesity resulting from binge eating could contribute to feelings of depression. This condition may exacerbate negative eating disorder beliefs and a lack of motivation for positive behavioral change.

Nutrition counseling in eating disorder treatment

Resuming healthy eating habits after living with an eating disorder can be challenging. Receiving coaching and advice related to nutrition for eating disorders from a registered nutrition professional is usually required. The National Eating Disorder Association advises including nutrition counseling as part of the overall treatment plan for an eating disorder.

Nutritional therapy may be able to assist in your recovery in several ways, such as by:

  • Offering insight into possible health effects of eating disorders
  • Assisting with planning healthy meals and food intake
  • Addressing fears about excessive weight gain

Because training requirements for nutrition professionals may be variable and hard to understand, choosing someone with an appropriate certification may be helpful. The American Dietetic Association recommends working with a registered dietitian (RD) as part of eating disorder treatment. 

Risks of unmonitored food reintroduction with an eating disorder

Recovery from eating disorders can place you at risk of refeeding syndrome. This is a dangerous form of electrolyte imbalance that can occur when people who have been nutrient-deprived for a long time begin eating larger amounts. Effective medical supervision can prevent refeeding syndrome, so working with a doctor along with a dietitian is often advisable as part of treatment for eating disorders involving food restriction.

Psychological treatment for eating disorders

While nutrition therapy can assist with building healthy eating behaviors, it may work best as a supportive treatment alongside mental health treatment. Psychotherapy can play a significant role in helping an affected individual rebuild their self-esteem, reframe negative eating disorder beliefs, and work toward adjusting a distorted body image. 

Some talk therapies that may be effective for eating disorders include:

Getty/AnnaStills
Get support for eating disorder symptoms

Online eating disorder treatment

Receiving therapy online can be an alternate option for mental health care for those with eating disorders. Many patients find virtual therapy through a platform like BetterHelp to be more convenient than face-to-face treatment due to the greater flexibility in scheduling it offers, and because you can log on to appointments from anywhere with an internet connection. Fitting in therapy alongside nutritional counseling, meal planning, and visits to a physician may be easier when you can attend remotely.

Online interventions for eating disorders are a newer approach, but evidence for their effectiveness is growing. According to a research review published in 2023, for example, current studies suggest that internet-based cognitive behavioral therapy can be effective for the “prevention, treatment, and relapse prevention” of eating disorders.

Takeaway

Eating disorders can disrupt a healthy nutritional balance in both minor and severe ways, with health consequences ranging from brittle nails and fatigue to organ failure and death. Negative nutritional effects can come from both food restriction and episodes of overeating. A registered dietitian may act as a valuable source of support in treating these illnesses and addressing their effects.
Healing from eating disorders is possible
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
Get the support you need from one of our therapistsGet started