Anorexia Nervosa (cont.)

Medical Author:

Roxanne Dryden-Edwards, MD

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• Anorexia nervosa facts
• What is anorexia nervosa?
• Who is at risk for anorexia nervosa?
• What causes anorexia nervosa?
• How is anorexia nervosa diagnosed?
• What are anorexia symptoms and signs (psychological and behavioral)?
• What are anorexia symptoms, signs, and complications (physical)?
• What is the treatment for anorexia nervosa?
• What is the prognosis (outcome) of anorexia nervosa?
• How can anorexia nervosa be prevented?
• The future of anorexia nervosa
• Where can a person get help for anorexia nervosa?
• Patient Comments: Anorexia Nervosa - Treatments
• Patient Comments: Anorexia - Share Your Experience
• Find a local Psychiatrist in your town
• Anorexia Nervosa Index

Most of the medical complications of anorexia nervosa result from starvation. Few organs are spared the progressive deterioration brought about by anorexia.

• Heart and circulatory system: Although not life-threatening, an abnormally slow heart rate (bradycardia) and unusually low blood pressure (hypotension) are frequent manifestations of starvation and are commonly associated with anorexia. Of greater significance are disturbances in the heart rhythm (arrhythmia). A reduction in the work capacity of the heart is associated with severe weight loss and starvation.
• Gastrointestinal complications are also associated with anorexia. Constipation and abdominal pain are the most common symptoms. The rate at which food is absorbed into the body is slowed down. Starvation and overuse of laxatives can seriously disrupt the body's normal functions involved in the elimination process. While liver function is generally found to be normal, there is evidence that some individuals with anorexia develop changes in enzyme levels and overall damage to the liver.
• The glandular (endocrine) system in the body is profoundly affected by anorexia. The complex physical and chemical processes involved in the maintenance of life can be disrupted, with serious consequences. Disturbances in the menstrual cycle are frequent, and secondary amenorrhea (absence of menstrual periods) affects about 90% of adolescent girls with anorexia. Menstrual periods typically return with weight gain and successful treatment. Hormonal imbalances are found in men with anorexia as well. Continual restrictive eating can trick the thyroid into thinking that the body is starving, causing it to slow down in an attempt to preserve calories. When anorexia occurs in a person who also has diabetes mellitus (a tendency toward very high blood sugar levels), the risk of death is higher than in people who have either anorexia or diabetes mellitus alone.
• Kidney (renal) function may appear normal. However, there are significant changes in kidney function in many people with anorexia, resulting in increased or decreased urination or potentially fatal potassium deficiency. Other long-term effects may include diabetes insipidus, which is characterized by excessive urination and extreme thirst.
• Bone density loss (osteopenia or thinning of the bones) is a significant complication of anorexia, since women acquire 40%-60% of their bone mass during adolescence. Studies have shown that bone loss can occur fairly rapidly in girls with anorexia. While some studies have shown that bone density may be restored if overall health improves and anorexia is successfully treated, other studies suggest that an increased risk for fracture may persist later in life.
• Anorexics who use a large quantity of laxatives or who frequently vomit are in danger of electrolyte imbalance, which can have life-threatening consequences.
• Anemia is frequently found in anorexic patients. In addition to having fewer red blood cells, people with anorexia tend to have lower numbers of white blood cells, which play a major role in protecting the body from developing infections. Suppressed immunity and a high risk for infection are suspected but not clinically proven dangers of anorexia.
• Contrary to what might be expected, anorexia nervosa is associated with a high total cholesterol levels.
• Other physical symptoms, other than the obvious loss of weight, can be seen. Anorexia can cause dry, flaky skin that takes on a yellow tinge. Fine, downy hair grows on the face, back, arms, and legs. Despite this new hair growth, loss of hair on the head is not uncommon. Nails can become brittle. Frequent vomiting can erode dental enamel and eventually lead to tooth loss. People with anorexia might also develop trouble maintaining a consistent body temperature.