Medical Complications
The physical, mental, and emotional effects of starving, stuffing, purging
The Silent Suffering
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Dehydration
Electrolyte Imbalance
Edema
Muscle Atrophy
Torn Esophagus
Gastrointestinal complications
Constipation
Poor Vision
Dry Skin/Dermatitis
Anemia
Bruising easily
Osteoporosis
Organ failure
Gastroesophogeal Reflux
Gastroparesis
Insomnia
Fatigue
Lanugo growth
Brittle Nails
Dental issues [such as enamel loss]
Hypotension
Hypertension (compulsive overeating)
Hypoglycemia
Heart palpitations
Bradycardia
Heart Attack
Diabetes (usually with compulsive overeating)
Leukocytopenia
Thrombocytopenia
Increased susceptibility to illness and disease
Ketoacidosis
Gallbladder disease
Amenorrhea
Arthritis
Vitamin and mineral deficiencies
Weakness
Dizziness, Fainting
Headaches
Cold hands & feet
Bloating
Hair loss
Body aches, pains
Abdominal pain
Cardiac Arrest
Swollen glands
Chronic sore throat
Scarring of hand, called "Russell's Sign"
Gastric Rupture
Cholesterol Issues
Infertility
Mental confusion
Depression
Shrinking of vital organs, including the brain and heart
Decrease in body temperature (which leads to feeling cold)
Ulcers
Acne
Poor Circulation
Muscle Cramps
Thyroid Dysfunction
Death
****NOTE****
This list is NOT comprehensive
Bone Loss
Bone loss (osteopenia, osteoporosis) as a result of an eating disorder is more common than you think. I was 20 years old when I was diagnosed with osteoporosis. It is important that you be screened for osteoporosis if you have struggled with an eating disorder, even if your weight is stable and your eating habits are normalized. Osteoporosis that occurs as a result of an eating disorder can be tricky to treat; It is often resistant to medicines such as Fosamax which are commonly used to restore bone loss. These types of medicines may be beneficial to individuals with postmenopausal osteoporosis but are typically ineffective in treating the bone loss of an eating disordered individual. Bottom line - the ONLY proven treatments for bone loss due to an eating disorder are weight restoration, healthy amounts of exercise and calcium supplementation.
The following is an article on osteoporosis that is featured on the Gurze website. To read the article on the website in its original context, please click here.
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Osteoporosis and Eating Disorders
If you have an eating disorder, you may be at increased risk of developing bone loss. Although it is very easy to think of osteoporosis as a disease that only affects older persons, about half of young female patients with anorexia nervosa have osteoporosis. Further, about 85% of partially recovered anorexia nervosa patients have bone mineral deficiencies, even if they have regained their periods and are within 10% of ideal body weight. Patients with bulimia nervosa or eating disorders not otherwise specified (EDNOS) are also at risk of osteoporosis, especially if they have had anorexia nervosa in the past or have had episodes of amenorrhea or significant weight loss. Female athletes who restrict their eating or who have amenorrhea may also be at increased risk of developing bone loss. Also, not only women develop osteoporosis, men with anorexia nervosa are also at risk .
The damage caused by osteoporosis is often silent. Hip fractures are painful and easily detected, but fractures of the lumbar spine may initially be painless. Osteoporosis is, for the most part, a silent, ongoing disorder, discovered only after fractures occur.
What is Osteoporosis?
In osteoporosis, the bones are weakened by loss of bone tissue (a condition called osteopenia, pronounced os-te-o-peen-ia), making a person much more susceptible to fractures. Osteoporosis is defined by the World Health Organization as bone mineral deficiency that is 2.5 standard deviations (SD) below the mean peak value in young adults (T score). Osteopenia is a T score between 1 and 2.5 SD below the mean peak value.Although we think of bone as solid and stable, in reality our bones are constantly being remodeled as bone is reabsorbed and new bone is laid down. In fact, about 10% of the bone in our bodies is replaced each year. Bone mineral mass increases during childhood and adolescence, and near peak bone mass is reached by about age 15. A smaller amount is produced until about age 30; after this, we lose about 1% of our bone mass per year. Bone loss can accelerate at any age, and can do so with excessive weight loss (as in anorexia nervosa) and excessive exercise. Throughout our lives, there is a dynamic balance between bone formation and bone resorption. This balance can be upset by many factors, including lack of adequate nutrition and hormonal influences.
Exercise can also influence bone mineral density. Moderate weight-bearing aerobic exercises, such as walking, can slow bone loss, but very strenuous exercise can speed bone loss.
Diagnosing Osteoporosis
Several diagnostic aids are now available to diagnose osteoporosis. Certain chemicals act as markers of bone formation and bone resorption and can be measured with blood tests. Markers that indicate lower-than-normal levels of bone formation include calcitonin, a hormone secreted by the thyroid gland, and type-1 procollagen carboxy terminal propeptide. Markers of bone resorption that have been found to be increased in women with anorexia nervosa include serum type-1 collagen carboxy terminal telopeptiode. Another helpful blood test measures serum estradiol levels; estradiol is the strongest of the naturally occurring estrogens.
In women at risk, an x-ray test can clearly show bone loss. Dual energy x-ray absorptiometry, or DEXA, is used to examine two areas at greatest risk, the hip and lumbar spine (low back).DEXA is a little more expensive than regular x-rays, and less expensive than CAT scans, but is more precise and you are exposed to much lower levels of radiation. The test is quick, easy, and painless, and involves a scan of the hip and lower spine.
Treatment
The mainstays of current treatment are weight restoration, normalizing body composition (particularly fat content), and use of calcium and vitamin D supplements. Estrogen supplementation (without weight gain) does not stop further bone loss or correct low bone mineral density.
Restoring weight. For young teens,body fat content should be at least 17%; adult women should aim for a body fat composition between 22% and 25%. Gaining weight helps, but maynot fully restore bone mass.
Calcium intake. The average American Consumes less than 800 mg of calcium per day. The National Academy of Sciences recommends 1300 mg of calcium/day for children 9 to 18, 1000 mg per day for adults 19 to 50, including pregnant and lactating women, and 1200 mg/day for everyone over 50 years of age. Although it hasnt been proved that calcium can help restore bone in patients with anorexia nervosa, the current recommendation is that patients eat 1,500 mg per day of calcium, preferably in calcium-rich foods such as milk (see Table 1, "Calcium Content of Some Common Foods"). Also, many non-dairy foods are now fortified with calcium. If it isnt possible to get the full requirement from food alone, oral calcium supplements may be the answer. Vitamin D, 400 international units (IU)/day, is also recommended because it helps the body absorb calcium. Calcium tablets are usually easy to take and cause few symptoms. Sometimes calcium carbonate tablets may cause constipation, bloating, and excess gas. If this is the case, individuals should switch to a different brand and increase your fluid intake. People who have a tendency to form calcium stones in the urinary tract are usually advised not to take calcium supplements. Calcium supplements come in a variety of forms. Some come from natural products such as oyster shell or bone. Others are marketed mainly as antacids (like Tums, for example). Calcium carbonate and phosphate preparations have the highest amount of elemental calcium, about 40%. Calcium citrate contains 21% elemental calcium; calcium lactate and calcium gluconate contain 13 and 9% elemental calcium, respectively. There is little evidence that one type of calcium is more effective than another in preventing osteoporotic fractures; calcium citrate may be better absorbed, however.
Moderate exercise. Moderate exercise, such as walking or yoga may be helpfulonce your weight is restored. Strength training may also be useful. It is a real challenge: exercise may lessen appetite and slow continuing weight gain in a person recovering from anorexia. Also, some patients may become compulsive about exercise.
Is there any good news about osteoporosis? The good news is that increased awareness can lead to earlier diagnosis and treatment. Media campaigns promoting getting adequate calcium in the diet and the importance of moderate exercise are helping raise awareness of this devastating disease.
Powers, MD, Pauline. "Osteoporosis and Eating Disorders." Bulimia.com. Gurze Books. Web. 16 Feb. 2010. <http://www.bulimia.com>.
The following is an article featured on the Joy Project's website regarding rebound water retention.
WATER WEIGHT AND MALNUTRITION
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One of the most frustrating things that an eating disordered person experiences is seemingly unexplained fluctuations in their weight from day to day. A normal person's weight will fluctuate 2-3 pounds on any given day. For an eating disordered person, the fluctuations can be even more dramatic. And when an eating-disordered individual wakes up one morning 5 lbs heavier than the day before, this can send them into a frenzy, and many will try to compensate by purging, exercising, or using laxatives or diuretics. Ironically, starvation itself, as well as the compensatory ED behaviors are to blame for much of the instability in their weight!
EDEMA is the term used to describe the accumulation of excess fluid in the body. Edema can occur in different places on the body, but is often found in the abdomen, face, or hands and feet of an eating disordered individual. There are a number of different ways in which a person's eating habits or eating-disordered habits can result in this excess fluid accumulation:
INSUFFICIENT PROTEIN INTAKE: Protein in the blood (especially albumin) help to hold salt and water in the body's cells. When the amount of protein in the bloodstream gets too low, fluid from the cells seeps out into the area around the cells.
PURGING: Vomiting causes a loss of potassium and acids from the stomach, which results in a low level of potassium in the body (hypokalemia). Potassium is an electrolyte, along with Magnesium, Calcium, and Sodium. These electrolytes interact with each other in a delicate balance. Excess or insufficient amounts of one can result in excess or insufficient amounts of another. The kidneys also try to aid in restoring the balance by filtering extra amounts of complementary electrolytes out of the body. This can result in excess urine production, which results in dehydration. Also, loss of potassium and other electrolytes changes the osmolarity of cells, which means that fluid from within the cells is pushed out into the area around the cells, causing edema.
DIURETIC USE: The use of diuretics can induce a state of dehydration. The body reacts to the dehydration by holding onto as much water as it can. Many eating-disordered individuals react to this 'rebound' water retention by taking more diuretics, which worsens the dehydration, which causes more rebound water retention. Diuretics also cause loss of potassium, which is another cause of edema. Caffeinated drinks, which are popular among those who are restricting their food intake have a diuretic effect.
LAXATIVE ABUSE: Laxatives work by pulling extra water into the large intestine, which causes waste in the intestines to be forced out more quickly. However, it also causes a loss of potassium, and potassium loss eventually results in water retention. Because extra water is lost through the large intestine, overall levels of fluids in the body drop, which means- (you guessed it) dehydration! And again, dehydration results in rebound water retention.
EXCESS INTAKE OF WATER: Eating-Disordered individuals commonly drink large amounts of water and other fluids in an attempt to control hunger or to fill their stomach. Many individuals crave salt as a result of dehydration; however, excess salt intake can often worsen edema. It is also common for eating-disordered individuals to crave extremely strong-tasting things, and salt is a common craving.
Source:
"Water Weight and Malnutrition." Joyproject.org. The Joy Project. Web. 12 Apr. 2010. <http://www.joyproject.org.
You think it won't affect you?
Eating Disorders are diseases. Our bodies were not created to run on empty. Even if you don't realize it, your eating disorder is affecting your body. Eating disorders hurt you, and they will kill you.
Eating disorders do not discriminate. They can happen to any person, male or female, of any race, in any walk of life.
It does not matter what you look like. Many people who struggle with eating disorders don't "look like" they have one. Death can come for the overweight, underweight, or 'healthy weight".
The following information was taken from Marcia Herrin's Nutrition counseling in the Treatment of Eating Disorders:
"As the body attempts to maintain basic functioning on low caloric intake, long-term health maintenance is 'put on hold'. Consequently, hormone levels, bone health, muscle maintenance, and even brain, heart, and other organ cells are sacrificed...Muscle weakness, fatigue, and eventually muscle breakdown are also likely. cerebral atrophy has been described in patients with anorexia nervosa and some patients with bulimia nervosa."
Herrin, Marcia. Nutrition Counseling in the Treatment of Eating Disorders. New York: Brunner-Routledge, 2003. Print.
What has anorexia done for me?
It has left me with medical and psychological scarring. It has wrecked my life, health, and relationships.
I have osteoporosis and osteopenia in my spine, arms, and legs. I have joint pain and I have lost almost 2 inches in height. I can't do some of the things that others enjoy because I might injure myself or break something.
My digestive system is wrecked. I have constant sore throats and reflux.
I have virtually no gag reflex.
I have gastroparesis and malabsorption.
I have had two surgical procedures connected to my digestive system as a result of years of restricting and purging - a Cholecystectomy (gallbladder removal) and an Upper GI Endoscopy (to investigate throat lacerations and ulcers).
I have chronic stomach pain.
I have been near organ failure due to low body weight and low fat percentage.
I have kidney issues.
Arthritis is settling in.
I have had skin irritations on and off due to malnutrition.
I have been dehydrated and I've had electrolyte imbalances and deficiencies so many times I've lost count.
I've been to the ER so many times you wouldn't believe it.
I've been evaluated by almost every kind of doctor, therapist, and specialist that you could think of.
I've spent far too much time in hospitals.
I've been Inpatient or residential 3 times.
I've spent countless hours in therapy, talking in circles.
I've grown apart from everyone in my life at some point.
Anorexia is not pretty. It is not fun. It takes you and it ruins you, and you don't even know it's happening.
To read more about my experiences, visit the moderator page.
UNDER CONSTRUCTION
sufferers speak out about what their eating disorder has done to their body.
please contact me if you would like to contribute.
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Don't let your life...pass you by...
