Complication of Eating Disorders
Eating disorders are a group of serious conditions in which you’re so preoccupied with food and weight that you can often focus on little else. The main types of eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder. Eating disorders can cause serious physical problems and, at their most severe, can even be life-threatening. Most people with eating disorders are females, but males can also have eating disorders. An exception is binge-eating disorder, which appears to affect almost as many males as females. Treatments for eating disorders usually involve psychotherapy, nutrition education, family counseling, medications and hospitalization.
Anorexia nervosa is a very serious illness that has a wide range of effects on the body and mind. It is also associated with other problems, ranging from frequent infections and general poor health to life-threatening conditions. Some researchers believe that it should not be approached as a simple eating disorder but as a serious condition requiring staging according to severity.
At this time, no treatment program for anorexia nervosa is completely effective. Recovery rates vary between 23 – 50%, and relapses range from 4 – 27%. Recovery takes an average of 5 – 6 years from the time of diagnosis. Up to 30% of patients do not recover. Even after treatment and weight gain, many patients continue to display characteristics of the disorder, including perfectionism and a drive for thinness, which could keep them at risk for recurrence.
Eating disorders are progressive in nature. Eventually the person who has the eating disorder will begin to experience physical consequences of varying degrees. Eating disorders cause a wide variety of complications, some of them life-threatening. The more severe or long lasting the eating disorder, the more likely you are to experience serious complications. Complications may include:
- Ophthalmologic: Transient blurred vision, dark circles, puffiness under the eyes.
- Cardiovascular: Hypotension, Bradycardia, ECG abnormalities.
- Gastrointestinal: Abdominal pain and fullness, irritable bowel syndrome, malabsorption of nutrients, fatty infiltration of the liver, pancreatitis.
- Renal: Chronic dehydration, tubular and collecting system abnormalities due to electrolyte abnormality, predisposition to renal stones.
- Dermatologic Dry skin, loss of subcutaneous tissues and fat in general, fine lugano hair.
- Effects On The brain and central Nervous System: Lack of REM sleep, hypothalamic abnormality including lower body temperature, loss of shivering response, cold intolerance, and malfunction of entire temperature regulating system due to chronic malnutrition, EEG abnormality.
- Fluid and Electrolyte abnormality: Skeletal muscle weakness, diminished reflexes, abnormal gastrointestinal motility, cramps, constipation, cardiac effects, irregular rhythms and sudden death, impaired renal function, emotional instability and chronic fatigue.
- Body Chemistries: Uric acid can be elevated, cholesterol is usually increased, carotene is elevated, hypoglycemia.
- Hematologic abnormalities: anemia, bone marrow may be deficient or hypocellular.
- Psychological: Isolation and withdrawal from family and friends, striving for an abnormal body weight, fear of gaining weight, talk about feeling fat, depression, difficulty eating in front of others, vomiting, frequent strict dieting, compulsive exercising, mood swings, suicidal ideation, dishonest eating behavior, weight determines self esteem, eating for emotional comfort, disturbance of REM sleep patterns, ritualistic eating behavior, substance abuse history, history of addictive relationships, sexual acting out and acting in, spending disorder, shoplifting, preoccupation with physical symptoms.
- Gynecologic: Loss of menstrual periods, Infertility, atrophic vaginitis, Loss of sexual appetite, breast atrophy.
- Orthopedic: Osteoporosis, loss of muscle mass leading to muscle weakness.
- Endocrine: Decrease in heart rate, sluggish reflexes, dry skin, cold intolerance, and various abnormalities of the hair, abnormal calcium levels.
- Dental: Increased dental caries (cavities), loss of enamel and dentin, increased sensitivity to heat and cold, pyorrhea, lacerations and contusions of the oral cavity from the use of objects to induce vomiting, obsessive-compulsive dental behavior.
- Pulmonary: Aspiration pneumonia.
- Cardiovascular: ECG abnormalities due to electrolyte disturbance, myocardiopathy due to ipecac.
- Gastrointestinal: Abdominal pain, bloating and fullness, esophageal perforations and lacerations, esophagitis, gastritis, gastric ulceration.
- Renal: Tubular abnormalities due to electrolyte abnormalities, azotemia due to dehydration.
- Orthopedic: Osteoporosis, stress fractures.
- Dermatologic: Scars on the knuckles while inducing vomiting.
- Fluid and Electrolyte abnormalities Fluid and Electrolyte abnormalities, skeletal muscle weakness, abnormal GI motility, cramps, frequent urination at night due to diuretics, constipation, emotional lability.
- Chemistries: Increase in uric acid, uncrease in cholesterol.
- Miscellaneous: Swelling of the lymph glands.
- Psychological: Isolation and withdrawal from family and friends, striving for an abnormal body weight, fear of gaining weight, talk about feeling fat, depression, binge eating, difficulty eating in front of others, vomiting, overuse of diuretics and or laxatives, overconcern with body shape and weight, frequent strict dieting, compulsive exercising, mood swings, suicidal ideation, dishonest eating behavior, weight determines self esteem, eating for emotional comfort, disturbance of REM sleep patterns, ritualistic eating behavior, substance abuse history, history of addictive relationships, sexual acting out and acting in, spending disorder, shoplifting, preoccupation with physical symptoms, rage addiction.
- Heart problems
- Multiple organ failure
- Suicidal thoughts or behavior
- Absence of menstruation (amenorrhea)
- Bone loss
- Stunted growth
- Digestive problems
- Kidney damage
- Severe tooth decay
- High or low blood pressure
Some research suggests that anorexia nervosa has the highest death rate of any psychiatric disorder. According to different studies, the risk for early death is higher for people with the following conditions or characteristics:
- Being younger
- Having bulimia anorexia (twice as high in this group than in the anorexic-restrictor types)
- Being severely low in weight at the time of treatment
- Being sick for more than 6 years
- Having been previously obese
- Having an accompanying severe psychological disorder including personality disorders
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