Self-starvation and a refusal to eat enough food to maintain a healthy weight are the characteristics that set anorexia apart from other psychological problems. When the body doesn't get enough food, it's denied the nutrients it needs to function, and medical complications often follow. Not all sufferers will experience all (or even some) of the complications listed here, but if anorexia is not treated, medical complications will eventually arise.
One of the first physical symptoms that loved ones notice in someone with anorexia is their emaciated appearance. The sufferer may attempt to conceal this by wearing larger clothes and long sleeves. These larger clothes may also be an attempt at staying warm, as most people with anorexia report feeling cold most of the time, and hypothermia (low body temperature) may also ensue. Fatigue is another commonly-reported symptom in eating disorders, and low blood pressure can contribute to lightheaded-ness and fainting.
Skin and Hair Problems
Many people who have anorexia report that their scalp hair begins to thin, and their fingernails become brittle over time. Dry, pale skin is another common complaint. Lanugo, a thin, downy-type hair, may grow on the body in an attempt to insulate it in the absence of necessary fat. Hands and feet may also become purplish or blue in color due to problems with temperature regulation, and yellow-tinted skin sometimes results from an excess consumption of certain vegetables.
A very common complaint among people with anorexia is that they become uncomfortably bloated after meals. This may be caused by something called gastroparesis, or a slowing of the emptying of the stomach. If you experience this, your dietician can help you choose foods that will minimize symptoms. This generally improves with weight restoration.
Along with delayed emptying of the stomach, constipation is a common complaint. It's important to avoid using laxatives to counteract this symptom, unless you're directed to do so by your physician. Your treatment team can also help you find other options, such as increasing your fluid or fiber intake.
Cardiovascular (Heart) Problems
Cardiac problems are not uncommon in anorexia. These can be a major cause of morbidity and even mortality. Common cardiac problems seen in sufferers of anorexia include a low heart rate (bradycardia), irregular heart rhythms (arrhythmias,) and low blood pressure (hypotension). Heart failure can be a complication of severe anorexia. In addition, the physical structure of the heart can be affected as a result of anorexia; this may contribute to mitral valve prolapse, a typically non-threatening condition in which a valve between the left upper chamber and left lower chamber doesn't close properly. Electrolyte imbalances are a common consequence of eating disorders—and a major condition contributing to medical interventions and hospitalization.
The endocrine system is also affected by anorexia--a common problem being with the reproductive system. Females who have anorexia experience amenorrhea, or an absence of their menstrual period. Abnormalities in thyroid and other hormones are common as well. Some physicians will use hormone replacement therapies to treat these conditions, although the problems typically correct themselves with weight restoration. Long-term fertility problems have been reported in people who have recovered.
Bone & Skeletal Problems
Although osteoporosis (low bone mass) is commonly thought to be a problem of aging, it is also seen in teenagers and young adults with anorexia. Osteoporosis results in extremely fragile bones, and unfortunately, it's present in about 40% of women with anorexia. Osteopenia, the precursor to osteoporosis, is present in 92% of women with anorexia. Depending on the extent of bone loss and the duration of the illness, even those in recovery may experience persistent bone issues.
Renal (Kidney) Problems
Significant problems with kidney functioning can sometimes be a complication of anorexia.
If you or someone you know is suffering from anorexia, please seek treatment. The longer that anorexia is left untreated, the more likely you are to experience medical complications.
Costin, C. (2007). The eating disorder sourcebook (3rd Ed.). New York, NY: McGraw Hill.
Mehlher, P.S., Birmingham, L.C., Crow, S.J. & Jahraus, J.P. (2010). Medical Complications of Eating Disorders. In C.M. Grilo & J.E. Mitchell (Eds.), The treatment of eating disorders: A clinical handbook (66-82). New York, NY: The Guilford Press.