Physiological Complications

Physiological Complications

There are frequently seen with those suffering from eating disorders or who have had a history of an eating disorder a vast array of physiological complications and health risks. No two individuals are the same. Their bodies may respond and react differently to the abuse which they succumb to under eating disorder behaviors. Very rarely can someone who "dabbles" in eating disorders (no matter which Anorexia, Bulimia, or Compulsive Overeating) simply walk away from the behavior alone. Additionally, it is not uncommon to experience a switching of behaviors from one to the other or to additional self destructive behaviors like self injurious behavior, compulsive spending, gambling, substance abuse, and stealing behavior to state a few.

As a therapist I have to be very in tuned with the possible complications more now than ever since insurance companies are not very helpful in providing the right levels of care an individual may need. For the most part to date insurance companies are dictating treatment and eating disorders are Illnesses they decline adequate treatment for very frequently. Individuals suffering from eating disorders and their family members need help in understanding the serious ramifications of these destructive behaviors on the body, soul, and mind of the individual.

Electrolyte Imbalances


Minerals make up the electrolyte system. They are essential for the balanced chemistry of the body and its ability to function correctly. They ensure healthy nerve and muscle impulses, kidneys and heart, blood sugar levels and the delivery of oxygen to the cells of the body. When this system is disrupted the results can be devastating including heart attacks and stokes. You will see Electrolyte Imbalances especially with behaviors associated with purging, (vomiting, abuses of diuretics and laxatives) as well as in drowning the body by binging on large quantities of fluids such as water, milk, soda.

Dehydration


This is caused by the depletion (frequently seen with purging behaviors) or lack of intake of fluids into the body. Restricting, vomiting, laxative and diuretic abuse, and extended exercise without appropriate hydration are the primary causes. Symptoms include: Possible dark circles under eyes, a "drawn" look to the face itself, dizziness, weakness, and darkening of urine. In extreme cases it can lead to kidney failure, heart failure, and death.

Dehydration

Malnutrition


Can be caused by significant under eating and in some cases overeating to the point of flooding the body and its systems. It can also be seen with binging and purging behavior especially when the individual is purging following everything eaten. The body requires fuel (food) as its primary energy source and when deprived of that it can result in respiratory infections, kidney failure, blindness, heart attack and death.

NutriQuest - Body of Evidence

Hyponatremia


A flooding of the system with water. (Drinking more than eight 8 ounce glasses of water a day.) **One client I worked with drank 5 gallons of water per day** Often seen with those who binge on fluids. This is a very serious condition which requires immediate medical attention. Due to the influx of water the body cannot balance its sodium level adequately and can cause fluid in the lungs, the brain to swell, nauseousness, vomiting, severe confusion and even death. It can also appear as a drug overdose to medical personal because of an enormous amount of strength an individual may experience in conjunction with some psychotic and delusional orientations.

Muscle Atrophy


A wasting away of muscle tissue and a decrease in muscle mass due to the body feeding off of itself. Usually accompanies restricting.

Lanugo


An unusual soft downs hair on the face, back or arms. This is caused by the body's protective mechanism in malnutrition to help keep the individual warm. It is a result of hormonal imbalances. It may take an extended period of time for this to go away after the individual begins eating appropriately due to the body's need to protect itself.



Edema


This is a swelling of the soft tissues as a result of excess water accumulation and retention. Pitting Edema is the type of swelling which when you apply pressure to the swollen area an indentation is left. It is most common in the legs, feet and fingers of all three eating disorders. For Bulimics and Anorexics it can also be present in the abdominal area. Can be caused by laxative and diuretic abuse.

Re-Feeding Edema


A very serious condition which requires medical supervision. It usually occurs during the time the individual who has been depriving themselves of sustenance and begins to eat again. Generally one of the causes of this edema is the lack of Protein in the system. Patients or clients who resume normal eating should be monitored for this because it is a natural reaction of the body to the reintroduction of food.



Impaired Neuromuscular Functioning


Inability to be able to move in a normal fashion. Due to vitamin and mineral deficiencies.

Temporary Paralysis


An extreme weakness of the muscles which may disable the individual to move at all. Frequently caused by low levels of potassium but also by the degeneration of nerve cells in the spinal cord or in the brain which have been deprived of essential nutrients. After onset they may occur more frequently and more severely and may lead to permanent muscle weakness and possible death.

Periodic Paralysis Association

Esophageal Reflux


This is a regurgitation of partially digested items in the stomach, mixed with acid and enzymes. This can lead to damage in the esophagus, stomach, and larynx. This can be a precancerous state to the esophagus and voice box and requires medical attention and medication often. Often seen in bulimics who purge through vomiting, reflux can become so bad that food cannot be kept down at all and purging becomes involuntary for the individual.


Gastroesophageal
Reflux Disease

Barrett's Esophagus


A condition associated with Cancer of the esophagus and caused by reflux. It brings about a change in the cells of the esophagus.

Tears in the Esophagus


These are exactly what they sound like, rips or tears in the esophagus caused by the unnatural and consistent purging of food. Keep in mind vomiting for the normal individual is only meant as a way of evacuating food from the stomach when something is wrong. It is not meant to be done on any regular basis so when one purges one is forcing the body to do something it is only meant to do under certain circumstances. As a result tears may occur and the individual may begin to notice vomiting blood when purging.

Mallory-Weiss tears


Also associated with purging through vomiting. It is a tear in the gastroesophageal junction.

Cancer


The development of cancer cells of the throat and Larynx due to acid reflux. Seen in bulimics who purge.


Cancer of the Larynx

Digestive Difficulties


There can be two issues in this area. One is a deficiency in digestive enzymes which leads to the bodies inability to properly digest food and absorb nutrients. This may lead to malabsorption problems, malnutrition, and electrolyte imbalances. Additionally, When one purges one risks a change in the signals from the stomach to the brain resulting in slowed digestion because the body has become accustomed to purging behavior. For bulimics this can be disturbing because the small intestine does not send its signal to the brain to tell the individual that they are full at the appropriate time. Additionally, the individual tends to feel full for a longer period of time. Which is very uncomfortable for the individual trying to recover from an eating disorder.

DigestInfo.com
Pancreatitis

Digestive enzymes attack the pancreas. This can be very painful. It can be caused by the repeated stomach trauma of vomiting, alcohol consumption or the excessive use of laxatives or diet pills.


Pancreatitis

Peptic Ulcers


Caused by increased stomach acids, high consumption of caffeine as seen in some forms of diet pills or alcohol consumption.

Cramps, bloating, constipation, diarrhea, incontinence.


Increased or decreased bowl activity. Many patients are treated for Irritable Bowel Syndrome.

Auto Immune System Weakening


Chronic Fatigue Syndrome is one eating disorder patients complain of however other syndromes are very possible.

Weakness and Fatigue


Caused by insufficient nutrients or malnutrition, electrolyte imbalances, vitamin and mineral deficiencies, increased depression, insomnia and heart problems.

Swelling in face


Particularly noticeable where the glands lie connecting the upper and lower jaws. Often follows purging by vomiting.

Bloodshot appearing eyes or tiny blood vessels torn on the face.


A direct result of violent purging by vomiting behavior.

Gastrointestinal Bleeding


A bleeding which occurs in the digestive tract which primarily is seen through elimination or blood in the stool.

Gastric Rupture


A sudden perforation or rupture in the stomach.

Hair Loss, Dry Skin, Brittle Lusterless Hair, Brittle Nails


Vitamin deficiencies

Seizures


Due to dehydration there is an increased risk to anoretic and bulimic individuals of seizures (which are surges of electricity within the brain). In these individuals lesions on the brain may develop as a result of long-term malnutrition which lack the oxygen- carrying cells the brain requires to function adequately causing chemical imbalances.


Anorexia and Seizures

Low Blood Pressure, Hypotension


A condition brought about by malnutrition, dehydration and a lowering of the body temperature. Can cause heart arrhythmias, shock or myocardial infarction.

Orthostatic Hypotension


This is seen as a sudden drop in blood pressure when changing positions from sitting or laying down to the standing position. The individual may experience a momentary inability to see, dizziness, blurred vision, passing out heart pounding and headaches.

Orthostatic Hypotension

High Blood Pressure, Hypertension


Seen primarily in compulsive overeaters the blood pressure elevates beyond 140 over 90. It causes abnormal thickening of the heart muscle resulting in heart attacks, additionally it may cause strokes fatal or brain damaging, and kidney failure.


Hypertension

Hypoglycemia


A disturbance in blood sugar resulting in Low Blood Sugar especially seen in anoretic or bulimic patients. Sweating and shakiness are symptomatic and can indicate problems with the liver or kidneys which can lead to neurological and mental deterioration. Dietary attention is important.


Reactive Hypoglycemia home page

Diabetes


A high blood sugar as a result of an inadequate production of insulin. Often seen in malnourished individuals as well as compulsive overeaters. For some this condition may be treated with dietary changes. Some patients who develop diabetes which requires medical attention and medication during the eating disorder are able as they recover more fully to be rid of the symptoms of diabetes, but need to be watched medically for a recurrence. Some warning signs are frequent urination and inability to quench thirst, nervousness, weakness, trembling, weak rapid pulse, seizures, and possible appearance of intoxication.

Eating Disorders and Diabetes

Ketoacidosis


A state which involves high levels of acids which build up in the blood caused by the body burning fat rather than sugar and carbohydrates to get energy. The shift from utilizing carbohydrates as energy to fat results in the formation of ketoacids. Kidneys are overwhelmed by the continuous production of ketone bodies resulting in profound acidosis. Common causes are alcohol abuse, starvation, excessive purging, dehydration and hyperglycemia. Untreated diabetes can cause ketoacidosis (also known as DKA).

Kidney Infections and Potential Kidney Failure


The function of the kidneys is to purify the poisons from the body, regulate acid concentration, and maintain water balance. The risk to difficulties with the kidneys increases with dehydration, infection and low blood pressure, and vitamin deficiencies. Untreated diabetes causes significant strain on the kidneys and can lead to kidney failure.

Amenorrhea


Loss of Menstrual Cycle because the hormone Oestrogen secreted by the ovaries ceases to be produced. This can lead to Osteoporosis and Osteopenia.

Osteopenia


A below normal bone mass indicating a calcium and Vitamin D deficiency which leads to Osteoporosis.

Osteoporosis


A thinning of the bones with a reduction in bone mass due to a depletion of calcium and bone protein. This leaves bones vulnerable to fractures. A bone density test is helpful in evaluating damage caused from eating disorder behaviors of restriction, binging and purging.


Osteoporosis and Related Bone Diseases



TMJ Syndrome


A form of degenerative arthritis within the tempero-mandibular joint in the jaw. This is often seen in bulimic patients who purge through vomiting causing unnecessary strain on the joint. There is often pain in the joint area, with difficulty chewing as a result, and headaches.


The TMJ Association

Dental Problems


Stomach acids and enzymes from vomiting can cause erosion of tooth enamel especially seen on the insides of the teeth where the tongue meets the teeth. This erosion ultimately leads to severe decay and lays the ground work for gum disease. Vitamin D, calcium deficiencies, and hormonal imbalances can lead to decalcification of the teeth.

Heart Attack, Cardiac Arrest, Dysrhythmia, Angina (chest pain)

and Irregular Heartbeat


Sudden heart attacks can cause permanent damage to the heart or death. A cardiac arrest is sudden death. Electrolyte imbalances which include potassium deficiency, extreme orthostatic hypotension, low blood pressure, slow heart rates, malnutrition, hormonal imbalances high blood pressure, high cholesterol, accumulations of fat deposits around the heart muscle can all be contributing factors with involve complications with the heart. All eating disorders have the potential for serious complications with the heart and even death.

Cardiac HealthWeb

Liver Disturbances and Failure


The liver is a very important organ of the body. It works to eliminate waste from cells and works in conjunction with your digestive system. Some patients attempt suicide through the use of acetaminophen which causes in some cases extreme liver damage and can ultimately lead to death. Also the abuse of Ipecac Syrup also causes damage to the liver and cannot be eliminated from the body.

Infertility


This is a condition which leaves an individual unable to have children. In eating disorders it may be caused by the lack of menstrual cycle, and other hormonal imbalances. Malnutrition and various vitamin deficiencies can also make it impossible to carry a child to full term. Additionally the lack of proper nutrition during pregnancy can lead to the birth of a baby with birth defects.


International Council on Infertility

Problems During Pregnancy


Due to malnutrition, dehydration, vitamin and hormone deficiencies pregnancies while actively involved in eating disorder behavior puts the unborn child at high risk of chronic illness, still birth, and death.

CoMorbidities Seen Associated With Eating Disorders

Death


Ultimately eating disorders which are very self destructive in nature and can be view as slow attempts at suicide behavior can lead to heart attacks, strokes, internal bleeding, gastric rupture, perforated ulcers liver failure, kidney failure, pancreatitis, and suicide.