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Medical Complications: Part 1

As many as 600,000 to 900,000 Canadians meet diagnostic criteria for an eating disorder. 80% of these individuals are women and girls. Eating Disorders also affect men and boys. Weight is not always the clinical marker of an eating disorder. People that have normal weights can also have an eating disorder. Eating disorders, such as Anorexia Nervosa, Bulimia Nervosa, Other Specified Feeding and Eating disorders, Binge Eating Disorders are serious illnesses that can be deadly. Individuals can develop life threating medical complications and often have other debilitating illness. The devastating symptoms of an eating disorder lead to serious consequences and risks to an individual’s mental and physical health and can compromise other parts of their lives such as personal relationships, current and future education and employment and overall quality of life. The mortality rate for individuals struggling with anorexia nervosa is estimated between 10-15% and Bulimia Nervosa is about 5%.

Health Consequences of Anorexia Nervosa

The body is denied the essential nutrients that it needs to function normally. There may be depletion of nutrition stores, vitamins, minerals, electrolytes or malabsorption. The body attempts to accommodate this by slowing all of its normal processes to conserve energy which can result in medical consequences such as:

·       Slowing of the heart rate and lowering of the blood pressure; symptoms such as chest pain, heart palpitations, irregular beats or arrhythmias, shortness of breath or edema

·       Muscle loss and weakness. The heart is also a muscle so it is affected significantly and can cause heart failure, heart arrhythmias, cardiac arrest and death

·       Severe dehydration can occur which can cause the kidney function to be altered

·       Liver function alteration

·       Decreased metabolic rate

·       Poor healing and alteration in immune system functioning

·       Bone mineral density loss or osteoporosis which can result in dry, brittle bones with poor bone healing or mineralization

·       Fainting, fatigue and overall weakness can be caused by poor nutrition, anemias, dehydration, low blood pressure, slow heart rate or other heart problems

·       Hair loss is very common, dry skin is also very common, development of lanugo or a downy layer of hair all over the body can develop in the body’s attempt to keep itself warm

·       Intolerances of the body to cold or marked sweating or hot flashes

·       Loss of menstrual cycle or amenorrhea, irregular menses, loss of libido, infertility

·       Gastrointestinal effects such as pain, bloating, acid reflux, constipation or hemorrhoids

·       Seizures, memory loss, poor concentration, insomnia, depression, anxiety, obsessive behaviours, self-harm, suicidal ideations or attempts

Health Consequences of Bulimia Nervosa

Many of the above consequences can be present in Bulimia Nervosa. The recurrence of binging and purging can affect the digestive system and can also lead to electrolyte and chemical imbalances in the body affecting the heart and other major organs. Some of these include:

·       Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death

·       Electrolyte imbalances and loss of potassium, sodium and chloride because of purging behaviours can also lead to dehydration

·       Possible rupture of the esophagus or inflammation or erosion or ulceration of lining from vomiting

·       pancreatitis

·       Changes in the gastrointestinal system, diarrhea, constipation, incontinence and chronic problems with the misuse of laxatives

·       Tooth decay, dental enamel erosion, discoloration, loss of teeth, gum recession or oral lesions, lacerations from the stomach acids during frequent vomiting

·       Parotid gland enlargement

Health Consequences of Binge Eating Disorder

Many of the associated clinical risks are similar to the health risks of obesity and they can include:

·       Hypertension

·       Dyslipidemia or high cholesterol and triglycerides

·       Heart disease as a result of elevated cholesterol and triglyceride levels

·       Development of type II diabetes

·       Gallbladder disease

·       Development of varicose veins

·       Hiatal hernia

·       Arthritis, sciatica or other mobility issues related to the wear and tear on major joints

Eating disorders are complex illnesses that can have harmful consequences on an individual and impact their physical health. They do not discriminate about any body system. They can compromise all regulatory systems of the body including the immune system, digestive system, skeletal system, cardio vascular system and reproductive system.  The effects on physical health can occur rapidly or may deteriorate over a longer period of time. Chronic illnesses can be a direct outcome from the harmful effects of an eating disorder. Some medical complications can resolve quickly as an individual recovers from their eating disorder and others such as osteoporosis can have lasting effects. However recovery is possible and is also complex requiring nutritional, psychological and often vocational or relational treatment.

Written By: Catherine Miller

References:

Mehler, Philip & Anderson, Arnold (2010). Eating Disorders: A guide to medical care and complications, 2nd edition.

Report of the Standing Committee on the Status of Women: Eating Disorders Among Girls and Women in Canada (November 2014) Available at: http://www.parl.gc.ca/content/hoc/Committee/412/FEWO/Reports/RP6772133/feworp04/feworp04-e.pdf

Putting Eating Disorders on the Radar of Primary Care Providers (CWEDP-2010) Available at https://www.haltonhealthcare.on.ca/site_Files/Content/Documents/PDFs/Eating_Disorders_Tool.pdf

Eating Disorders, Critical Points for Early Recognition and Medical Risk Management in the Care of Individuals with Eating Disorders, 2nd edition (AED Report 2012) Available at: http://www.aedweb.org/web/downloads/Guide-English.pdf