Understanding The Health Effects Of Eating Disorders
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The prospect of a loved one experiencing an eating disorder or living with one yourself can be terrifying, as you may be unsure what to expect. Disordered eating can lead to various adverse health outcomes and may also be associated with mental and behavioral challenges. Understanding the possible effects of eating disorders may leave you better equipped to identify them and seek support.
People with eating disorders may experience nutritional deficiencies, leading to reduced energy and health problems like weakness, esophageal damage, and poor immunity and wound healing. Severe cases may lead to organ damage or failure, potentially resulting in a person’s death. Below, review the known risks of common eating disorders and strategies that may be effective for treatment.
Eating disorders defined: Beyond anorexia nervosa
The most well-known eating disorder is anorexia nervosa (often called anorexia), a condition in which a person avoids, drastically reduces, or places excessive restrictions on their food intake. However, an eating disorder can involve other unhealthy eating behaviors, including bouts of uncontrolled eating or intense aversions to specific foods. All disordered behaviors can have lasting ill effects on the body.
Some people with eating disorders experience a strong cognitive and attentional fixation on food, weight loss, and thinness. An exaggerated fear of gaining weight and appearing heavy may motivate their attempts to decrease food energy intake. At the same time, these individuals may view food as a source of stress relief and psychological comfort, leading to patterns of compulsive eating. Below are brief overviews of the various types of eating disorders known to clinicians.
Anorexia nervosa
Anorexia nervosa causes severe restrictions on eating. Some affected individuals may also experience episodes of binge eating — uncontrolled and excessive food intake — followed by purging behavior aimed at counteracting possible weight gain. Purging can include induced vomiting or inappropriate use of laxatives or diuretics.
Bulimia nervosa
Often called “bulimia,” this disorder is characterized by repeated episodes of binge eating followed by inappropriate compensatory behaviors meant to avoid gaining weight. These behaviors may include purging, such as forced vomiting, periods of intense fasting, or excessive physical exercise.
Binge eating disorder (BED)
Though anorexia and bulimia are more well-known, binge eating disorder (BED) is the most common form of eating disorder in the United States. This condition is defined by repeated episodes of overeating that seem out of one’s control, often involving foods high in sugar, salt, and fats. Unlike anorexia or bulimia, binge eating disorder does not include compensatory behaviors like purging or fasting.
Avoidant-restrictive food intake disorder (ARFID)
In avoidant-restrictive food intake disorder (ARFID, an individual may avoid entire broad categories of food (often limiting themselves to bland or dry foods) or eat only tiny portions. In contrast to anorexia or bulimia, this restriction is typically motivated by an aversion to certain sensory qualities of non-preferred foods or anxiety about the possibility of choking or regurgitating. Some people with ARFID may forget to eat or struggle to recognize hunger.
Rumination disorder
Also called “rumination syndrome,” rumination disorder is defined by repeatedly regurgitating food after eating, then re-chewing and swallowing it or spitting it out. The condition is more common in children but can occur in adults.
Pica
Pica is an eating disorder more frequently seen in children but can affect adults in some cases. The characteristic symptom is compulsively eating non-food objects or substances, such as earth, chalk, paper, fabric, uncooked starches, or paint.
Other eating disorders
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes an additional category for eating disorders that don’t quite fit with the criteria for the above disorders. Possible examples include purging behavior without binge eating or an erratic mixture of restricted eating, binge eating, and purging.
Health effects of malnutrition in eating disorders
The most drastic negative impacts of many eating disorders come from disruptions in a person’s intake of nutrients and food energy, whether through food restriction, fasting, or purging food before food can be digested. This risk can lead to serious medical complications that may affect virtually every system in the body. Below are potential impacts:
- Heart and blood circulation issues such as low blood pressure, low or arrhythmic heart rate, or cardiac arrest
- Gastrointestinal difficulties, reported in more than 90% of patients with restrictive anorexia, such as pain, nausea, constipation, difficulty swallowing, and a distended or ruptured stomach
- Decreased bone density resulting from hormonal imbalance from lack of nutrition, leading to an increased risk of fractures
- Neurological and cognitive deficits caused by atrophied neural tissue, including attention, concentration, mental flexibility, and decision-making challenges.
- Blood abnormalities such as anemia, causing persistent feelings of coldness or weakness, or hypoglycemia — low blood sugar — which can pose severe risks like coma and death
- Fertility disruptions such as amenorrhea, miscarriage, and stillbirth, which may occur in women with eating disorders
The above is not an exhaustive list of the potential health risks of malnutrition resulting from eating disorders, but it may offer a sense of how broad and severe the effects can be. Failure of organ systems like the cardiovascular or gastrointestinal systems may lead to sudden death in individuals with severe eating disorders.
Health effects of purging behavior in eating disorders
In addition to reducing nutrient and energy intake, purging behaviors seen in conditions like bulimia and anorexia can directly damage the body. A person who regularly forces themself to vomit or abuses laxatives and diuretics may experience effects including:
- Damage to the throat and esophagus, resulting in difficulties like laryngitis, soreness, and bleeding—Severe damage could result in a life-threatening esophageal rupture
- Swelling of the cheeks and throat due to enlarged salivary glands
- Erosion of teeth by stomach acid
- Severe dehydration and electrolyte imbalances, potentially leading to dizziness, cramps, heart arrhythmia, kidney damage, seizures, and death
- Acid reflux
- Disrupted colon function
- Prolapsed rectum
Some of these complications can be deadly, while others may severely impact an affected individual’s quality of life.
Health effects of excessive exercise in eating disorders
Along with purging, some people with eating disorders attempt to compensate for eating by engaging in inappropriately intense or frequent physical activity. This behavior may lead to additional health risks by increasing a person’s shortage of metabolic energy and the strain on their body. Those impacted may be more likely to experience exercise-related injuries and have more difficulty recovering due to a disrupted metabolism. Exercise may also increase the risk of heart and blood pressure difficulties, dehydration, and other health concerns.
(H2) Health effects of binge eating in eating disorders
Binge eating involves episodes of compulsive, excessive eating, often to the point that the person becomes uncomfortably or painfully full. Some people binge primarily on nutritionally unhealthy foods, such as those with a high salt or sugar content, which can lead to additional complications. The resulting medical complications can include:
- Unhealthy body weight, often including obesity
- Diabetes and metabolic syndrome
- Stomach rupture
Excessive weight gain resulting from binge eating may increase your risk for other health difficulties, including heart disease, arthritis, sleep apnea, and forms of cancer.
The mental health impacts of eating disorders
The relationship between eating disorders and other mental illnesses is complex, but research suggests that these conditions are often accompanied by symptoms such as depression, anxiety, and low self-esteem. Some reviews indicate that roughly 50% to 70% of people with anorexia or bulimia may also experience major depressive disorder.
Eating disorders may lead to social isolation and loneliness. Those living with these conditions often try to conceal their eating habits from others, leading them to withdraw socially. The resulting lack of interpersonal engagement can increase their distress and weaken their support system, worsening any existing mental health difficulties.
A high rate of substance use disorders exists among people with eating disorders. People with these conditions may use intoxication to cope with the same stressors that prompt their disordered eating behavior. In some cases, an individual attempting to recover from an eating disorder may exhibit an increase in substance use as an unhealthy form of compensation.
Suicide risk in eating disorders
Low self-esteem, shame, lack of pleasure, and isolation in eating disorders can lead to a higher risk of suicidal behavior. One 2019 study estimated that college students with an eating disorder were eleven times more likely than their peers to attempt suicide.
How to recognize the effects of eating disorders
Not all health risks are evident to an outsider, and recognizing an eating disorder before it progresses to the point of serious harm may be crucial for the health of the person affected. Below are potential visible signs that can help you identify when someone you care about has an eating disorder:
- Preoccupation with food, weight gain or loss, and thinness
- Excessive self-criticism related to appearance and weight
- Avoidance of meals or making excuses to eat little
- Frequent disappearance or visits to the bathroom after meals
- Bad breath or heavy use of breath mints, gum, etc. to conceal vomiting
- Scars from teeth on knuckles
- Dizziness or weakness
- Thin, brittle hair and nails
- Fine hair growth all over the body
- Large caches of food or food containers from binge eating
- Sudden disappearance of large amounts of food
- Dramatic weight gain, loss, or fluctuation
- Wearing baggy clothes to conceal body shape
- Highly restricted dietary choices (such as avoiding large categories of food)
How are the effects of eating disorders treated?
Successfully treating an eating disorder often relies on a combination of psychotherapy, medical management, and support from family and friends. Certain approaches may work better for specific conditions. For example, people with anorexia may benefit most from family-based interventions, while cognitive-behavioral therapy (CBT) and antidepressants can be effective for bulimia. Various psychotherapeutic approaches may treat binge eating disorder, and supplementing treatment with antidepressants or psychostimulants may lead to increased effectiveness.
Supervision from a medical professional may also be necessary to help severely malnourished people with eating disorders return to a healthy weight and metabolism. Otherwise, they may be at risk of refeeding syndrome, in which rapid shifts in electrolyte levels incite potentially lethal disruptions to various organ systems.
The BetterHelp platform is not intended to provide any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action without consulting a qualified medical professional.
Alternative mental health treatment for an eating disorder
Some people with eating disorders may choose to seek treatment over the internet. Online therapy through a platform like BetterHelp can connect you with a broader group of providers than you may be able to access in your immediate area, matching you with a therapist based on your preferences. This process can make locating a therapist with whom you’ll have a productive connection more accessible. In addition, you can schedule sessions when convenient for you, including outside of standard business hours.
Early research into the use of web-based treatments for eating disorders indicates that they can offer effective treatment. One research review from 2020 found that online treatments generally lead to significant reductions in eating disorder symptoms. Consult with a physician alongside seeking therapy, as eating disorders can cause physical health risks.
Takeaway
What do eating disorders result from?
While the exact cause is not known, researchers believe that multiple factors may contribute to eating disorders. For example, a person may be at higher risk of developing eating disorders if they have a family history of them or other mental illness, if they have certain differences in brain chemicals, or if they already have other mental health conditions. Other risk factors include family or societal pressures, personality traits like perfectionism, and having been bullied, among others.
How do eating disorders affect the people around you?
Eating disorders can affect the friends and family members of an individual in various ways as well. Family members may experience emotions like guilt, frustration, exhaustion, or anxiety related to the health of their loved one. That's why family therapy—where each family member has the chance to share their experiences and concerns and work toward healing—is a common component of eating disorder treatment.
How does an eating disorder affect the human brain?
Eating disorders can affect the human brain in different ways depending on the type of disorder, its severity, and how long symptoms are experienced before they are treated. For example, research suggests that behaviors related to anorexia nervosa—especially when severe and untreated—may alter “the brain’s reward response process and food intake control circuitry,” which can make these behaviors harder to stop.
Other research on anorexia notes that brain function can also be significantly affected by malnourishment—and a report by the National Eating Disorders Collaboration highlights the fact that a person doesn't have to appear significantly underweight for their body to be experiencing the effects of self-starvation. Anorexia symptoms in a person of any body size or weight can result in trouble making decisions, solving problems, and regulating emotions. It can even change brain chemistry, making symptoms of anxiety and depression more likely.
These changes may also skew an individual’s perception of reality, making them put too much focus on body shape and losing weight, which can further reinforce disordered eating behaviors. Over time, even serious complications like brain damage can occur due to malnourishment. These are just some examples of how one eating disorder in particular can affect the brain.
How do people with eating disorders feel?
The way a person with an eating disorder feels can vary depending on many factors. In general, many eating disorders affect body image and brain function. As a result, a person may experience a distorted body image—even if they are of average weight or low body weight—as well as low self-esteem, which can further fuel disordered eating behaviors. An individual may also experience a variety of emotions related to their symptoms, from anxiety to guilt and shame to frustration to intense fear. Some eating disorders may cause a person to withdraw socially as well, which can make them feel lonely and isolated and affect both the person’s mental health and the person’s physical health.
What affects eating disorders?
Many factors can affect the development and course of eating disorders (EDs). For example, co-occurring mental health conditions can make a person more likely to develop an eating disorder, and people with eating disorders may be at higher risk of developing other conditions too. Anxiety, depression, obsessive-compulsive disorder (OCD), and substance use disorders (formerly “substance abuse”) are commonly comorbid with EDs.
The environment someone lives or works in can also affect the development and course of an eating disorder. Those who work in industries with restrictive body standards, for instance, like athletics or modeling, may be at higher risk of developing an ED. The same is true for individuals who grow up in households or cultures with narrow standards for appearance, or where their appearance, eating habits, or food eaten are frequently commented on.
What are 3 mental health risks associated with disordered eating?
There are various, serious risks associated with disordered eating, which is why it's so important to try and prevent eating disorders. Whether disordered eating leads a person to lose weight/experience extreme weight loss or gain weight, they may experience both physical and mental health complications.
Examples of potential mental health risks associated with disordered eating include the risk of developing a comorbid mental illness, the risk of furthering body image issues, and the risk of social self-isolation and loneliness. Examples of potential physical health risks associated with disordered eating include damaged tooth enamel, high blood pressure, organ damage, muscle weakness, and many other potential effects on a person's physical body that may require medical care.
How do eating disorders impact families?
Eating disorders can cause stress and tension among families. Family members of a loved one with an eating disorder may experience a range of emotions, such as stress, guilt, frustration, and exhaustion. Seeking help can be important for both the individual with the eating disorder and their loved ones.
Families can seek support and resources from the individual's primary care provider, their local Health and Human Services office, eating disorder specialists, and mental health professionals or mental health care providers such as family therapists and psychiatrists.
What are the long-term effects of undereating?
Over the long term, undereating can have significant effects on both physical and mental health. Without the proper nutrition, a person's body and brain may not be able to function properly. They may develop a host of physical health complications, potentially leading to organ failure and death in extreme cases. Their mental health may also be affected, with stress, anxiety, depression, and other effects becoming more likely. This is why getting eating disorders diagnosed and receiving treatment as soon as possible can be so important. Treatment usually consists of therapy with a mental health professional as well as nutritional counseling and medical care as needed.
Can eating disorders cause permanent damage?
Yes; it’s possible for eating disorders to cause permanent damage. Severe undereating can result in permanent damage to the reproductive system, gut microbiome, immune system, and organ health. Severe overeating can cause high blood pressure, type 2 diabetes, and other long-term cardiovascular problems.
How to fix eating disorders like anorexia nervosa?
Treatment for eating disorders can vary depending on the type of disorder, its severity, any co-occurring mental health conditions, and other factors. It may involve some form of talk therapy, nutrition counseling, medical care, family therapy, and/or medication.
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