Eating Disorders And Cardiovascular Health: How Eating Disorders Impact Your Heart

Cardiovascular changes for the worse are very common in untreated eating disorders. Fortunately, many of them improve as the eating disorder is resolved.

Anorexia and your heart

Anorexia nervosa often results in serious cardiovascular changes. In fact, heart problems are the most common reason people who live with anorexia nervosa have to be hospitalized. Anorexia forces the body to conserve energy by lowering its basal metabolic rate. One of the ways that the body can reduce calories burned is by changing the metabolism of heart muscle. The heart pumps more slowly and its ejection fraction, the percentage of blood in the heart that leaves with each beat, falls drastically.

Frequently observed effects of anorexia on the heart include:

• Bradycardia, unusually slow pulse.
• Hypotension, low blood pressure resulting from slow pulse.
• Cardiomegaly, creation of larger chambers in the heart making pumping more difficult.
• Cardiomyopathy, death of the heart muscle, in response to chronic use of syrup of ipecac to induce vomiting, or deficiencies in magnesium and B vitamins.
• Loss of nitric oxide function in the peripheral blood vessels, making it difficult for them to constrict to increase blood pressure or to conserve blood in case of bleeding.
• Chest pain. This can be due to a relatively less severe condition known as mitral valve prolapse, which will improve after weight gain, or it can be due to a more severe condition known as
• Congestive heart failure, because of these changes.

Anorexia also makes it difficult to recover from the heart problems it causes. Brittle bones (osteoporosis), weak muscles, and fatigue make aerobic exercise impossible.

Binge eating disorder and your heart

Binge eating disorder and obesity have different effects on cardiovascular function. In obesity, the cardiovascular system responds to the constant load of a larger body that forces it to work harder. Bends and curves of arteries are subject to higher pressure. The body repairs damages to these small areas of especially high blood pressure with cholesterol. The cholesterol eventually calcifies into hard plaque that can “clog” the artery — but only in the areas of exceptionally high blood pressure.

Binge eating disorder causes the heart to have an unusually strong response to stress. Blood pressure surges out of proportion to stress hormones. There is a greater risk of “blowing out” an artery and causing an aneurysm. People who live with a binging and purging disorder lose electrolytes, especially potassium, by vomiting or the use of laxatives and diuretics. This can result in hypokalemia, clinically significant low potassium levels, which can result in:

• Ironically, a swollen abdomen.
• Severe constipation.
• Shortness of breath.
• Muscle cramps.
• Muscle pain due rhabdomyolysis, breakdown of muscle tissue.
• Depression, delirium, hallucinations, paranoia, and finally,
• Heart failure and death.

All of these consequences of low potassium levels can occur even in when the person who has the binge eating disorder is normal weight.

EDNOS and your heart

There is a diagnostic category of “eating disorder not otherwise classified” or EDNOS. Mortality rates in people who live with EDNOS tend to be higher than the rates of death in either anorexia or bulimia, perhaps because people who have EDNOS don’t get enough medical care. People who have EDNOS tend to have higher blood pressure than people who have anorexia, but lower blood pressure than people who have bulimia.

What’s the most important thing to do to keep someone with an eating disorder alive?

Sudden death, the sudden stopping of the heart, is the most common cause of death in people who have eating disorders. If you are taking care of someone who lives with an eating disorder, it is a good idea to learn cardiopulmonary resuscitation, also known as CPR. The sad fact is that CPR fails more often than it is successful, but there are people who survive with normal brain function after CPR (including the author of this article).

Even better, invest in an automatic electronic defibrillator (AED). The machine “knows” whether shock is needed to restart the heart. An AED only buys the cardiac arrest victim time to get to an emergency room, but it can make the difference between life and death.