Eating Disorders - The physical and psychological consequences of eating disorders

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Photo by: Jaimie Duplass

An eating disorder can have serious physical and psychological consequences. How serious these consequences are depends on how early an eating disorder is identified and treated. With help, the effects of an eating disorder can be treated; however, if an eating disorder is left untreated for years, some of the effects are irreversible and life-threatening. For these reasons, early detection and treatment is essential and can save a person's life.

The different types of eating disorders are often connected. In fact, 30 to 50 percent of people with anorexia exhibit signs of bulimia as well. Therefore, the consequences of the disorders are also connected. In other words, bulimia and anorexia often share physical, as well as psychological, consequences.

How Anorexia Nervosa Affects the Body

Anorexia causes many physical problems. For instance, it upsets the normal functions of hormones. For girls, this means the body is unable to produce enough of the female hormone estrogen because it does not have enough fat. This will cause an absence of menstrual cycles, called amenorrhea. For boys, anorexia causes a decrease in the production of the male hormone testosterone, which results in a loss of sexual interest.

An anorectic body lacks the protective layer of fat it needs to stay warm. To compensate for the lack of fat, lanugo (fine hair) will grow all over the body to keep it warm. Another problem anorexia causes is a decrease in bone mass. The body needs calcium for strong bones. Since an anorectic is not eating enough food, which is the source of calcium, the body's bones suffer and weaken. Later in life, this could result in a dangerous bone disease called osteoporosis.

Additionally, without the fuel it needs, an anorectic's body will respond as if it is being assaulted and begins to fight back in order to survive. To survive the body must have energy, but because the body has no food to turn into energy, it seeks out the muscles, and eventually, the organs (heart, kidney, and brain) for sustenance—often causing permanent damage to the organs in the process. This is the most serious consequence of anorexia and can possibly lead to cardiac arrest and/or kidney failure, both of which can result in death.

How Bulimia Nervosa Affects the Body

The frequent purging that occurs with bulimia does serious damage to the body. Self-induced vomiting can severely damage the digestive system. Repeated vomiting also damages the esophagus (throat) and eventually it may tear and bleed. Vomiting brings stomach acids into the mouth, causing the enamel on the teeth to wear away. As a result, the teeth may become weakened and appear ragged. There will also be an increase in cavities from vomiting.

Other consequences include swollen salivary glands, which gives some bulimics the appearance of having chipmunk cheeks, and cuts and sores on the knuckles from repeatedly sticking one's fingers down the throat to induce vomiting (known as "Russell's sign"). Stomach cramps and difficulty in swallowing are also common.

If laxatives (drugs that induce bowel movements) are abused, constipation will result because the body can no longer produce a bowel movement on its own. Abuse of laxatives and diuretics (drugs that expel water from the body through urination) can also cause bloating, water retention, and edema (swelling) of the stomach. Because the body is constantly being denied the nutrients and fluids it needs to survive, the kidneys and heart will also suffer. Specifically, a lack of potassium will result in cardiac abnormalities and possible kidney failure, which can also result in death.

How Binge-Eating Disorder Affects the Body

The physical effects of binge eating are not as severe as with anorexia and bulimia, namely because the body is not denied food or put through the painful process of purging. Nevertheless, there are some potentially serious consequences for binge eaters.

Since binge eaters may suffer from obesity, health complications such as diabetes or heart problems can develop. Health problems from yo-yo dieting can include hypertension (high blood pressure) and long-term damage to major organs, such as the kidney, liver, heart, and other muscles.

How Exercise Addiction Affects the Body

Many anorectics and bulimics exercise compulsively (constantly) in order to lose weight. Compulsive exercise is extremely dangerous and can cause many painful injuries, including stress fractures, damaged bones and joints, as well as torn muscles, ligaments, and tendons. Even worse, the injuries may become more serious as many compulsive exercisers will continue their routines despite their injuries.

When an eating disorder is successfully treated, the body can heal and return to normal. Sometimes, however, the eating disorder has continued for so many years that there is too much damage for a full recovery to occur. A person may have to live with a weak heart or kidney for the rest of her life. A woman may be unable to conceive a child because her reproductive system cannot function properly (due to the absence of menstruation). Also, a person may have to live with the debilitating bone disease osteoporosis.

How Eating Disorders Affect the Mind

The psychological consequences of an eating disorder are complex and difficult to overcome. An eating disorder is often a symptom of a larger problem in a person's life. The disorder is an unhealthy way for that person to cope with the painful emotions tied to the problem. For this reason, the emotional problems that triggered the eating disorder in the first place can worsen as the disorder takes hold.

An eating disorder can also cause more problems to surface in a person's life. Eating disorders make it difficult for people to perceive things normally because certain chemical changes take place when the body is deprived of nutrients. As a result, the body relies on adrenaline (a hormone that is normally released during times of stress and fear) instead of food for energy. Adrenaline naturally makes makes someone excited, which makes it more difficult to deal with painful emotions.

Research has shown that many people suffering from an eating disorder also suffer from other psychological problems. Sometimes the eating disorder causes other problems, and sometimes the problems coexist with the eating disorder. Some of the psychological disorders that can accompany an eating disorder include depression, obsessive-compulsive disorder, and anxiety and panic disorders.

In addition to having other psychological disorders, a person with an eating disorder may also engage in destructive behaviors as a result of low self-esteem. Just as an eating disorder is a negative way to cope with emotional problems, other destructive behaviors, such as self-mutilation, drug addiction, and alcoholism, are similar negative coping mechanisms.

Not everyone who has an eating disorder suffers from additional psychological disorders; however, it is very common. For this reason, psychological counseling is an essential part of recovery (see Chapter 15: Mental Health Therapies).

DEPRESSION. Depression is one of the most common psychological problems related to an eating disorder. It is characterized by intense and prolonged feelings of sadness and hopelessness. In its most serious form, depression may lead to suicide (the taking of one's own life). Considering that an eating disorder is often kept a secret, a person who is suffering feels alienated and alone. A person may feel that it is impossible to openly express her feelings. As a result, feelings of depression will worsen the effects of an eating disorder, making it difficult to break the cycle of disordered eating.

Feelings of depression will worsen the effects of an eating disorder, making it difficult to break the cycle of disordered eating. (Photograph by

Robert J. Huffman. Field Mark Publications

. Reproduced by permission.)

With counseling and support, it is possible to combat these negative feelings and prevent them from progressing over time. Recently, doctors have begun to prescribe antidepressant drugs, such as Prozac, to address the problems of depression resulting from an eating disorder. Prozac can help ease feelings of depression, which in turn gives a person better tools with which to fight an eating disorder. [For more information on depression, see Chapter 12: Mental Illness.]

OBSESSIVE-COMPULSIVE BEHAVIOR. Obsessions are constant thoughts that produce anxiety and stress. Compulsions are irrational behaviors that are repeated to reduce anxiety and stress. People with eating disorders are constantly thinking about food, calories, eating, and weight. As a result, they show signs of obsessive-compulsive behavior. If people with eating disorders also show signs of obsessive-compulsive behavior with things not related to food, they may be diagnosed with Obsessive-Compulsive Disorder (OCD).

Some obsessive-compulsive behaviors practiced by eating disorder sufferers include storing large amounts of food, collecting recipes, weighing themselves several times a day, and thinking constantly about the food they feel they should not eat. These obsessive thoughts and rituals worsen when the body is regularly deprived of food. Being in a state of starvation causes people to become so preoccupied with everything they have denied themselves that they think of little else.

FEELINGS OF ANXIETY, GUILT, AND SHAME. Everyone experiences feelings of anxiety (fear and worry), guilt, and shame at some time; however, these feelings become more intense with the onset of an eating disorder. Eating disorder sufferers fear that others will discover their illness. There is also a tremendous fear of gaining weight.

As the eating disorder progresses, body image becomes more distorted and the eating disorder becomes all-consuming. Some sufferers are often terrified of letting go of the illness, which causes many to protect their secret eating disorder even more.

Eating disorder sufferers have a strong need to control their environment and will avoid social situations where they may have to be around food in front of other people or where they may have to change their behavior. The anxiety that results causes people with eating disorders to be inflexible and rigid with their emotions.

Bulimics and binge eaters, specifically, experience guilt and shame with their disorders. This is mainly because, unlike anorectics, they are not usually in denial and they do realize that there is a problem. Bulimics will feel anxiety before, during, and after a binge and can only relieve this anxiety through purging. Purging, however, brings on overwhelming feelings of guilt and shame.

Binge eaters also feel anxiety during a binge, but because they do not purge, they feel ashamed over their lack of control around food.