Eating disorders (EDs) are mental illnesses in which someone struggles with their relationship to food and behaviors around eating. They are caused by a convergence of genetic, biological, social, and psychological factors that may differ from person to person. However, because EDs impact how someone nourishes and moves their body, these conditions can have serious health complications. This article highlights some of the medical complications that can arise from different types of eating disorders. Whether you’re concerned for yourself or a loved one, awareness is the first step toward early intervention and recovery.

Common Medical Complications in Eating Disorders

Eating disorders affect the entire body, from your brain to your bones. We’ll go into the most common health complications for each eating disorder diagnosis below, but here are some of the overarching ways that they can impact one’s body. 

• Cardiovascular System: Malnutrition and electrolyte imbalances can lead to symptoms like dizziness, chest pain, or an irregular heartbeat. These may be signs of bradycardia, arrhythmias, or low blood pressure.
• Gastrointestinal System: Extreme shifts in eating habits can cause abdominal pain and difficulty digesting food, which may point to gastroparesis, constipation, bloating, or acid reflux.
• Bone Health: Nutrient deficiencies can weaken bones over time, leading to osteopenia or osteoporosis, often presenting as brittle bones and sore joints.
• Endocrine and Hormonal Regulation: Caloric deficits impact hormone production, potentially resulting in amenorrhea, low testosterone, or hypothyroidism.

Anorexia Nervosa

Anorexia Nervosa (AN) is an eating disorder characterized by restrictive eating behaviors often leading to weight loss. Typically, people with AN have a fear of gaining weight and a distorted body image. There often is a denial of their low weight, which can sometimes be an initial obstacle to getting treatment. AN is the most well-studied eating disorder, although those studies often underrepresent minority groups. 

Health Complications of Anorexia Nervosa

Because AN is an eating disorder based around restriction, many of the health consequences are tied to malnutrition and energy deficiency. Energy deficiencies can cause muscle wasting and bone loss, leading to physical weakness. This energy restriction can also impact cardiovascular health. People with an AN diagnosis often exhibit low blood pressure readings (hypotension) and a decreased heart rate (bradycardia). In the worst cases, this can lead to ongoing issues with heart health, including ​​cardiomyopathy and premature death. Reproductive health is another area of concern, often due to hormonal disruptions. Those with AN may experience delayed puberty, menstrual irregularities, or even infertility. 

Bulimia Nervosa

Similar to Anorexia Nervosa, Bulimia Nervosa (BN) is often tied to negative body image. It manifests in cycles of binge eating—consuming large amounts of food in a short period—and purging, which includes behaviors like self-induced vomiting, laxative misuse, or excessive exercise.

Health Complications of Bulimia Nervosa

Because of the energy deficiencies, individuals with a BN diagnosis face many similar complications to those with AN. However, the nature of the bingeing and purging cycle is hard on the body in its own ways too. Using laxatives and vomiting can lead to severe dehydration and electrolyte imbalances, which can disrupt the heart’s functioning and lead to dangerous conditions like arrhythmias.

Frequent vomiting can also cause chronic throat inflammation, swollen salivary glands, and decaying tooth enamel due to prolonged exposure to stomach acid. These complications not only affect physical health but can also have profound emotional and social impacts, further exacerbating the disorder.

Binge Eating Disorder

Binge Eating Disorder (BED) involves episodes of consuming large amounts of food in a short period. These binge eating episodes are not related to one’s hunger level and are often done in secrecy. Many people with BED continue eating past the point of fullness, leading to emotional symptoms such as distress, shame, and guilt.

Health Complications of BED

Binge Eating Disorder can result in a range of cardiovascular and gastrointestinal problems. Overeating can put stress on the digestive system, which can lead to issues like acid reflux, stomach discomfort, and poor sleep quality. Over time, BED increases the risk of developing chronic conditions such as Type 2 diabetes, high blood pressure, and heart disease.

Avoidant/Restrictive Food Intake Disorder (ARFID)

Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder characterized by highly selective eating habits, disturbed feeding patterns, or both. Unlike anorexia nervosa or bulimia nervosa, ARFID is not motivated by a fear of gaining weight but rather by aversions to certain foods because of their texture, taste, or effects (e.g., choking or vomiting).

Health Complications of ARFID

ARFID can cause serious malnutrition. Even if someone appears to be eating regularly, a highly restricted diet may mean they aren’t getting the necessary nutrients to survive. This can lead to weight loss and disruptions in overall development, especially if the onset of ARFID happens before puberty, as it often does. 

Other Specified Feeding or Eating Disorders (OSFED)

OSFED (Other Specified Feeding or Eating Disorders) is a catchall diagnosis that includes disordered eating behaviors that don’t meet the strict criteria for others listed in the DSM-5. Subtypes of OSFED include “Atypical” Anorexia Nervosa (exhibit all symptoms of Anorexia Nervosa but remain within or above the “normal” weight range), Bulimia Nervosa of low frequency or limited duration, BED of low frequency or limited duration, Purging Disorder, and others.

Health Complications of OSFED

The health consequences of OSFED can be just as severe as those associated with other eating disorders. For example:

• Atypical Anorexia Nervosa may result in the same cardiovascular, bone, and hormonal complications as anorexia nervosa, despite the individual not being medically “underweight.”
• Purging Disorder can lead to throat inflammation, tooth decay, and electrolyte imbalances similar to bulimia nervosa.

Because OSFED encompasses a broad spectrum of behaviors, it is vital to address these conditions with the same urgency and care as other eating disorders to prevent long-term harm.

Mental and Emotional Health Complications

As we know, our physical and mental health are inextricably connected. Along with the physical consequences, eating disorders take a toll on one’s mental and emotional wellbeing. After all, EDs are mental illnesses and treatment requires holistic support.

Eating disorders often co-occur with other mental health conditions, like depression, anxiety, and obsessive-compulsive disorder (OCD). It’s important to understand everything that’s going on for a patient when seeking treatment to make sure that they get the care they need. Additionally, when there are co-occurring disorders in the mix, they can further exacerbate the stress of an eating disorder and potentially act as another barrier to seeking help.

Eating disorders may also increase the risk of suicide. Anywhere from one-quarter to one-third of people with AN, BN, or BED have thought about suicide. Addressing the mental and emotional pain of eating disorders is equally as important as treating the physical effects.

What to Do if You Notice These Signs

If you notice signs of physical or mental health complications associated with eating disorders, it’s important to intervene early and compassionately. Early detection, intervention, and access to treatment are important. Unfortunately, deeply-ingrained stigmas surround eating disorders and mental health, making it difficult to reach out for support. At The Alliance, we understand how tricky it can be to get someone care and support without intensifying feelings of shame or fear. That’s why our free helpline is staffed with mental health professionals who can offer empathy, a listening ear, and support in finding the best-fit care. 

When you call our helpline, we will help you put together a list of treatment resources that work for you. Whether inpatient or outpatient care, treatment may include medical monitoring, nutritional counseling, and therapeutic interventions that meet you where you’re at. Recovery is possible. For more information on how to receive help, please call us at 866-662-1235, email referrals@allianceforeatingdisorders.com, or visit findEDhelp.com.