We are pleased to share with you an overview of the general medical complications of eating disorders from Medical Director Dr. Joel Jahraus, MD, FAED, CEDS. We hope this post informs and educates on the co-occurring medical issues that are commonly associated with eating disorders.
While eating disorders are mental health diagnoses, they are far from pure mental health illnesses. There is likely no other mental health illness with the complexity of medical complications found in eating disorders. Anorexia nervosa has the highest death rate of any mental health illness and while suicide is certainly a serious problem with these illnesses, the majority of individuals that die of their illness die from multi-organ failure and heart complications in particular. Yet, no body system or organ is untouched by eating disorders.
The good news is that most of the medical complications are reversible with normalization of nutrition and weight, assuming they are discovered early enough and acted on by both the medical professional and the individual. That can be particularly challenging given the lack of education about eating disorders in medical schools and residencies. Furthermore, some clinicians may feel uncomfortable confronting an individual about a potential eating disorder given their perception of stigmatization and the patient’s potential anger about being confronted. Nevertheless, appropriate questions are absolutely necessary where there is evidence of an eating disorder and aggressive medical monitoring is imperative. Children and adolescents in particular are at risk given their limited physiologic reserve and risk of disruption of normal growth and physical maturation if the eating disorder persists.
In addition to the severity of the eating disorder on one’s medical status, refeeding can be just as complicated. A physically compromised body is fraught with refeeding perils and risk of worsening if aggressive monitoring and careful refeeding is not completed. The heart, in particular, may be compromised from longstanding malnutrition, both functionally and anatomically. It is often in a weakened state both from the pumping capacity but also electrically with a risk of irregular heart rhythms that can lead to sudden death. In addition, one cannot fully predict the risk due to severely malnourished states occurring in individuals of normal body weight whether over time or from rapid weight loss. Convincing patients of the medical risks and even convincing parents at times can be particularly challenging as they struggle to understand the altered physiology and risks of refeeding.