How Does an Eating Disorder Affect Your Physical and Mental Health?
Key takeaways:
Eating disorders can cause a wide variety of mental and physical health complications.
10% of people with eating disorders will die from their illness.
Anorexia has the highest death rate of all mental health conditions.
Eating disorders are illnesses that can cause changes to your eating habits and body image. Eating disorders are not a “phase” or a “choice.” They are serious medical conditions that can affect your mental and physical health. In some cases, an eating disorder can even lead to hospitalization or death.
Common eating disorders include:
Anorexia nervosa, restricting type
Anorexia nervosa, binge-eating/purging type
Bulimia nervosa
Binge-eating disorder
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Eating disorders and mental health
Many people with eating disorders have other mental health conditions, like depression, anxiety, or substance abuse. Mental health conditions can appear before, during, or after an eating disorder. Sometimes, these are called “co-occurring” when they happen at the same time as the eating disorder.
It’s not clear how eating disorders interact with other mental health conditions — whether one causes the other, or vice versa. It’s possible that these disorders are connected in the brain. It’s also possible that the physical and behavioral changes of one condition could be a risk factor for another.
But we do know this: Depression, anxiety, and other conditions are common in people with eating disorders. In one research study of people hospitalized with an eating disorder, 94% had a mood disorder (like depression), and 56% had an anxiety disorder. Personality disorders, OCD, and attention deficit hyperactivity disorder (ADHD) are also very common in people with eating disorders. And 25% of people with an eating disorder have symptoms of post-traumatic stress disorder.
Depression
Depression is a common mental health condition that affects your thoughts, feelings, and physical body. People with depression often feel sad, flat, or irritable. Depression can also cause some people to lose their appetite or to have a hard time taking care of their body (such as difficulties showering, eating, and dressing).
Some people with an eating disorder eat very small amounts of food. This can lead to being undernourished, which may be a risk factor for depression. And depression can make it harder to shop for groceries, cook for yourself, and even eat — all of which can worsen eating disorder symptoms.
Anxiety
Anxiety disorders are also common in people with eating disorders. People with anxiety disorders have intense, persistent fears that interrupt their day-to-day life.
Having an anxiety disorder may be a risk factor for developing an eating disorder. In fact, about 65% of people with eating disorders have at least one anxiety disorder. Most of the time, anxiety symptoms appear before the eating disorder and last even after the eating disorder is treated.
Substance abuse disorders
Substance abuse means using alcohol or drugs in a way that is harmful to yourself, your community, or both. Substance abuse disorders commonly co-occur with eating disorders. One study found that women with either a substance abuse or an eating disorder were 4 times as likely to develop the other type of disorder — compared with women who had neither one. And in another study, almost a third of women with a substance abuse disorder also had either anorexia or bulimia.
There’s also evidence that as eating disorder symptoms get worse, people tend to use more types of substances. Some people with an eating disorder use drugs to lose weight. Other people turn to drugs and alcohol to cope with the stress and shame of living with an eating disorder, or while facing the challenges of recovery.
Even if you don’t have a co-occurring mental health condition, living with an eating disorder can impact your emotional and social life. Eating disorders can cause people to be overly preoccupied with thoughts about their body weight, body shape, and eating. This can take time and energy away from relationships, work, and enjoyable activities.
Many people with eating disorders also end up feeling isolated and ashamed. It can help to find ways to talk with friends, family, and healthcare providers about what you’re experiencing, including other mental health symptoms.
Physical effects of an eating disorder
An eating disorder can increase your risk for developing other health problems. In some cases, these problems can be a direct result of extreme food restriction or the result of binges and purging.
Eating disorders can cause general physical problems such as feeling cold, poor concentration, and feeling slow or sluggish. Some parts of your body are especially at risk if your eating disorder is not treated.
Heart problems
Your heart is the muscle that pumps blood through your body. Eating too few calories can cause your muscles — like your heart — to break down, so your body can use the muscle tissue for food. Purging, using laxatives, or drinking too much water can also lower your blood mineral levels. Without enough minerals, your heart can’t do its job.
Here are some of the heart problems that an eating disorder can cause:
Abnormal heart rhythms: The heart needs to beat to a steady rhythm to work well. Some eating behaviors can cause the heart to beat irregularly.
An enlarged heart: When the heart grows too big, it doesn’t work as well.
Congestive heart failure: Some eating behaviors can weaken the heart. A weak heart has trouble pumping blood through the body.
Sudden cardiac death: The heart can stop beating suddenly, leading to death.
Low blood pressure: People with low blood pressure can’t get enough blood to all parts of the body. Some people with low blood pressure might faint.
Hormonal problems
Hormones are chemical messengers in your body. They help many of your body systems function smoothly. Your body is able to make all of the hormones that it needs from food (especially fat and cholesterol), but this can be hard for your body to accomplish if you’re only eating small amounts of food.
Here are some of the hormone problems that can be caused by eating disorders:
Hypothyroidism: Low amounts of thyroid hormone can cause hypothyroidism symptoms like fatigue and weight gain.
Abnormal periods: Low sex hormones can cause your periods to become abnormal or stop altogether (amenorrhea). This can lead to infertility.
Weak bones: Low sex hormones can also cause weak bones (osteoporosis), which increases your risk for broken bones.
Diabetes: Binge eating can make your body more resistant to insulin, a hormone that helps control your sugar levels. Insulin problems can lead to type 2 diabetes. And if you have type type 1 diabetes, it can become harder to manage.
High cholesterol: Eating too few calories can cause high cholesterol levels (blood fats), leading to problems with your heart and blood vessels.
Digestion problems
Your digestive system includes your:
Mouth
Esophagus
Stomach
Intestines
Anus
This system is how your body takes in nutrients (food) and gets rid of some types of waste (stool).
Eating disorders can cause major wear and tear on the digestive system, sometimes with life-threatening consequences. Food restriction and vomiting can also make it hard for your digestive system to follow its normal rhythms.
Eating disorders can cause problems throughout the entire digestive system:
Slow digestion (gastroparesis): Food restriction and vomiting can both interfere with normal stomach emptying and make it hard for your body to digest nutrients. This can cause pain, bloating, blockages, and bacterial infections.
Severe constipation: Low food intake and poor nutrition can weaken the muscles of your intestines. This can make it harder for your body to make stool and push it out. Laxatives can also damage the nerves in the gut, making it impossible to have a bowel movement without using them.
Stomach or esophagus rupture: Binge eating or vomiting can cause your stomach or esophagus to tear open. Both of these are life-threatening emergencies.
Sore throat: Frequent vomiting can cause a non-stop sore throat and make your voice hoarse.
Swollen jaw: Frequent vomiting can cause the glands in your throat and jaw to swell. This can also happen when you stop vomiting.
Stomach blockages: Eating large amounts of food can cause blockages in your stomach. This can block the circulation of blood in your stomach wall. When blood doesn’t get to part of your stomach, that part can die or get holes in it.
Gastro esophageal reflux disease (GERD): GERD is a condition that causes stomach acid to spill up into your esophagus. This can cause abdominal and chest pain and damage to your esophagus. GERD symptoms may be worse in people with an eating disorder.
Irritable bowel syndrome (IBS): People with IBS can have stomach pain and might have trouble having regular bowel movements or have loose stools. These symptoms can be worse in people with an eating disorder.
Impacts on brain
Your brain weighs less than 5 lb, but it still needs a lot of daily nutrients. If you eat a low amount of food every day, your brain can’t get the energy it needs. Not only can this make you feel hungry all the time, it can cause many brain-related problems, including:
Poor concentration: Not getting enough nutrients can affect your ability to focus during the day.
Problems sleeping: When your brain doesn’t get enough food, it goes into starvation mode. This can make it hard for you to fall asleep and stay asleep. Larger-bodied people are also at risk for sleep apnea, which makes you stop breathing while asleep.
Fainting or dizziness: If your brain does not get enough blood, oxygen, and food, it can cause you to lose consciousness.
Seizures: Some eating disorders can change your blood mineral levels (electrolytes). This can lead to seizures.
Other health consequences
Eating disorders can damage other parts of your body. For example, people with eating disorders may also have:
Dry and yellow skin
Brittle hair and nails
A fine layer of hair covering the whole body (lanugo)
Kidney failure
Anemia (low red blood cells)
A weakened immune system
Infertility
Eating disorders can kill
Eating disorders can be deadly. In research studies, the death rate for people with eating disorders is many times higher than that of the general population. And more people die from anorexia nervosa than from any other mental illness.
It might be hard to imagine that having an eating disorder can put your life in danger, but it can. Some people with eating disorders starve to death. An eating disorder can also make other medical conditions worse, leading to death. People with eating disorders frequently die from substance abuse or suicide.
The bottom line
Just like other medical conditions, having an untreated eating disorder can put you at risk for additional health problems — and even put your life at risk. If you (or someone you know) may be struggling with an eating disorder, think about reaching out for support. With the right treatment, you can recover from an eating disorder and allow your mind and body to begin to heal.
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