Anorexia causes serious health complications as weight loss and starvation progress. Starvation affects all areas of the anorexic’s body, including the heart. Binge and purge type anorexics may induce vomiting or laxative abuse, which may have serious side effects.
Mortality rates from anorexia nervosa are high. Some sources estimate death rates due to anorexia-related complications are as high as ten percent within the first ten years after diagnosis. The majority of these deaths are due to either starvation or suicide.
Heart Problems and Effects of Starvation
If anorexia nervosa damages the heart enough, anorexics can develop an irregular heartbeat known as sinus bradycardia (a low heart rate defined as a resting heart rate of less than 50 beats per minute).
If anorexia nervosa damages the heart to this extent, the anorexic should avoid both caffeine and exercise, both of which may trigger fatal heart arrhythmias, abnormal rhythms or rates in the resting heart. As many anorexics continue to exercise excessively in spite of starvation symptoms, the danger of arrhythmia is quite high.
In addition, other dangerous effects of anorexia include dehydration and electrolyte imbalances (imbalances in blood salts such as sodium), which can also cause cardiac arrhythmias and death.
Anorexics with severe heart muscle atrophy may react negatively to sudden intake of nutrients, especially high calorie or glucose nutrients. Because the cardiovascular system may react to sudden calorie intake, calorie intake is increased slowly during anorexia treatment.
Gastrointestinal Effects of Anorexia
Constipation is a common complication of anorexia. In fact, many cases of anorexia come to the attention of doctors when anorexics seek out treatment for constipation. Dehydration can arise with severe weight loss, starvation, and abuse of laxatives, so it is not surprising that it is such a common complaint among anorexics.
As anorexia progresses and starvation complications become more pronounced, a number of gastrointestinal problems may develop, both in combination with or independent from constipation. Gastrointestinal mobility slows, and it takes longer for the gastric system to empty. Some anorexics also develop abnormal muscle activity in the esophagus.
Gastric problems such as constipation, bloating, and a sensation of early fullness all tend to suppress the urge to eat, thus speeding up the process of weight loss and starvation.
Abuse of Laxatives
Approximately fifty percent of anorexics achieve weight loss through a binge and purge cycle. Purging is accomplished through self-induced vomiting, enemas, and laxatives. Abuse of laxatives is common among anorexics who purge.
Chronic abuse of laxatives damages stomach nerves and worsens constipation caused by starvation. Treatment of anorexics who abuse laxatives must be handled carefully. If laxatives are suddenly stopped, severe swelling and edema can occur within two to three days, causing a weight gain of ten to twenty pounds.
Obviously, a weight gain of this magnitude (even a temporary one) will cause anorexics anxiety and stress, and in a worst case scenario could lead to the anorexic refusing further treatment or attempting to lose the weight by returning to laxatives. Some anorexia professionals suggest slowly reducing the level of laxatives. Whether stopping laxatives “cold turkey” or slowly reducing laxatives, the anorexic must be made aware that abusing laxatives can be fatal.
Self-Induced Vomiting and Ipecac Syrup
As well as laxatives, anorexics may purge by using self-induced vomiting. This may be accomplished by sticking a finger down the throat, or by abusing ipecac syrup, a medication designed to induce vomiting in poison victims.
If abused on a regular basis, ipecac syrup can cause a number of complications, including damage to the heart, and muscles. Ipecac syrup can cause fast and irregular heartbeats, stomach cramps, fatigue, weakness and trouble breathing.
Anorexics in the later stages of starvation who also abuse ipecac are at serious risk for heart disease. Heart damage caused by excessive weight loss, combined with heart muscle damage caused by ipecac, can combine to cause life-threatening heart conditions.
Amenorrhea: A Real Danger of Anorexia
Female anorexics often suffer from amenorrhea, or the cessation of the menstrual cycle. Even a period of a few months is enough for amenorrhea to develop into osteopenia, which can eventually develop into osteoporosis. Osteoporosis increases the chances of stress fractures or bone abnormalities.
The risk of osteoporosis increases with extended amenorrhea, low protein intake, or low calorie intake, so anorexics are at high risk of osteoporosis. Smoking also increases the risk of osteoporosis.
Infertility and Birth Complications
In addition to potentially causing infertility, anorexia nervosa leads to an increased risk of miscarriages and cesarean sections in those who do become pregnant. Miscarriage rates for anorexics average thirty percent, as opposed to sixteen percent for women without the eating disorder.
Cesarean sections average three percent for women who aren’t anorexic, but C-section rates rise to sixteen percent in women with a history of anorexia nervosa. Babies born to women with anorexia nervosa have a lower than average birth weight, and a greater risk of being born prematurely.
Dangers of Water Intoxication in Anorexia
Anorexics often consume large amounts of water. Sometimes this is to blunt the appetite during self-induced starvation, or in the mistaken belief that drinking water will flush out calories and increase weight loss.
In other cases, anorexics may consume large amounts of water prior to doctor’s visits in an attempt to “water load,” or to pretend to have gained weight between appointments.
Excessive water consumption can lead to hyponatremia or water intoxication, in which too much water is ingested too quickly without replenishing electrolytes, especially sodium and potassium. Hyponatremia is a dangerous condition that can cause cerebral swelling, seizures, coma, and even death.
Other Dangers of Anorexia Nervosa
Anorexics are obsessed with weight loss and body appearance, and cannot see the effects that extreme weight loss and starvation have on their appearance. Brittle nails and blotchy yellow skin may both develop due to starvation.
In addition to the dangers of anorexia nervosa listed above, excessive weight loss and starvation can produce a series of other complications, including:
- enlarged parotid salivary glands
- hypoglycemia (low blood sugar levels)
- hypothermia (low body temperature)
- kidney stones due to dehydration
- rough scaly skin.