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Eating disorders have profound effects on every aspect of human heath unless they are successfully treated. Eating disorders also leave profound changes in families and personal relationships.

Anorexia nervosa, bulimia nervosa, and binge-eating disorder all can have profound complications for health and relationships.

Medical complications of eating disorders

Eating disorders can affect every organ, every tissue, and every cell in the human body. Here is a partial list of the medical dangers of untreated eating disorders:

  • “Chipmunk cheeks” caused by stones in the parotid glands.
  • Anal leakage, urinary incontinence, repeated urinary tract infections, vaginal prolapse, or uterine prolapse due to damaged or weak pelvic floor muscles.
  • Anxiety.
  • Arrhythmia (irregular heartbeat), cardiac arrest, and death.
  • Bloat, distended abdomen, flatulence, and halitosis.
  • Blotchy, dry skin with a yellowish tint.
  • Bluish skin, icy hands and feet.
  • Brittle hair.
  • Brittle nails.
  • Delayed growth or permanently small stature. The body may not be able to catch up when eating disorders occur before adulthood.
  • Depression. This depression may not respond to conventional antidepressants.
  • Destruction of tooth enamel.
  • Disruption of the menstrual cycle and resulting loss of fertility in women.
  • Electrolyte disturbances, especially low levels of potassium and sodium.
  • Erectile dysfunction in men.
  • Excess hair on the body and face, but loss of hair in the scalp.
  • Hypertrophy of the knuckles (in people living with an eating disorder that causes them to purge by self-induced vomiting).
  • Insomnia (too little sleep) or hypersomnia (too much sleep).
  • Kidney failure.
  • Liver damage.
  • Low blood pressure. Severely low blood pressure may be a warning signal that hospitalization is urgently needed.
  • Low body temperature. Like low blood pressure, low body temperature may be another signal that hospitalization is urgently needed.
  • Low estrogen levels in women. However, women who have eating disorders have an increased risk of developing polycystic ovarian syndrome (PCOS), which causes their bodies to make too much estrogen.
  • Low testosterone levels in men.
  • Low white blood cells counts and either weakened immune system or hyperactive immune system that causes autoimmune disease (by attacking hormones that regulate appetite and the brain’s hunger control centers).
  • Permanent loss of bone mass with osteoporosis as early as age 20. Dowager’s hump, fragile bones and joints.
  • Pernicious anemia due to lack of B12 and other B vitamins from the diet, or damage to the stomach’s ability to make intrinsic factor to absorb them.
  • Rupture of the esophagus during purging or binge eating.
  • Scanty or skipped menstrual periods.
  • Seizures. Some people who live with eating disorders have partial or absence seizures, without the violent body movements, but causing them to detach from their surroundings.
  • Up and down striations of the nails.
  • Bad judgment due to low blood sugar levels.

Psychological complications of eating disorders

Many people who live with eating disorders report that their psychological distress is worse than their medical problems. People who have eating disorders often live in constant fear that their problem will be found out and others will be disgusted by and reject them.

They may become hypervigilant in the fear that others will figure out their secret or catch them in some socially unacceptable behavior. They become obsessed with eating, or with finding ways to avoid accumulating body fat. They develop ritualized patterns of compulsive behavior. They feel they just don’t fit in anywhere.

Social complications of eating disorders

Eating disorders disrupt family dynamics. Members of the family may blame each other for the eating disorder. The costs of hospitalization and stays in rehab centers may disrupt family savings for college educations and retirement. They may fight over the expense of treatment. Younger siblings may feel neglected or deprived and become resentful of the older sibling that has the eating disorder, or an older sibling may feel that family resources that could support their success and enjoyment of life are going to treat the younger sibling who “chooses” to have an eating disorder.

Young athletes who have eating disorders face tensions at home and tensions in the gym. An athlete who hides symptoms of an eating disorder from family may also hide symptoms of an eating disorder from the coach. When the coach discovers the eating disorder, a decision has to be made about how to inform the parents. This can create tensions at practice It can inspire devious behavior by other athletes seeking the position on the team held by the person with the eating disorder.

Friendships and romantic relationships may be destroyed. The person who has the eating disorder may become anxious, depressed, and emotionally distant. Or they may become controlling in a passive-aggressive manner.

Social complications continue during recovery. Sometimes people who have eating disorders find that they have to leave old relationships that were triggering destructive behaviors. They may find that there were people in their lives who benefited from their having an eating disorder, making it easier to control them, and that these people will seek to sabotage them. And they may find that they have a new and completely different but greatly improved life that requires some time for adjustment.

  • da Luz FQ, Hay P, Touyz S, Sainsbury A Obesity with Comorbid Eating Disorders: Associated Health Risks and Treatment Approaches.Nutrients. 2018 Jun 27.10(7). pii: E829. doi: 10.3390/nu10070829. Review. PMID: 29954056.
  • Fairburn C. Cognitive Behavior Therapy and Eating Disorders. Guilford
  • New York, NY, USA: 2008. Vranian M., Blaha M., Silverman M., Michos E., Minder C., Blumenthal R., Nasir K., de Carvalho J.M., Santos R. The interaction of fitness, fatness, and cardiometabolic risk. J. Am. Coll. Cardiol. 201.
  • 59:E1754. doi: 10.1016/S0735-1097(12)61755-0.
  • Photo courtesy of SteadyHealth

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