Anorexia: The Body Neglected
What, exactly, does anorexia nervosa do inside the human body? The heart and bones suffer the most.
Anorexia nervosa takes an enormous toll on the body. But that's not all. It
has the highest death rate of any mental illness. Between 5% and 20% of people
who develop the disease eventually die from it. The longer you have it, the
more likely you will die from it. Even for those who survive, the disorder can
damage almost every body system.
What happens exactly? Here's a look at what anorexia does to the human
The first victim of anorexia is often the bones. The
disease usually develops in adolescence -- right at the time when young people
are supposed to be putting down the critical bone mass that will sustain them
"There's a narrow window of time to accrue bone mass to last a
lifetime," says Diane Mickley, MD, co-president of the National Eating
Disorders Association and the founder and director of the Wilkins Center for
Eating Disorders in Greenwich, Conn. "You're supposed to be pouring in
bone, and you're losing it instead." Such bone loss can set in as soon as
six months after anorexic behavior begins, and is one of the most irreversible
complications of the disease.
But the most life-threatening damage is usually the havoc wreaked on
the heart. As the body loses muscle mass, it loses heart muscle at a
preferential rate -- so the heart gets smaller and weaker. "It gets worse
at increasing your circulation in response to exercise, and your pulse and your
blood pressure get lower," says Mickley. "The cardiac tolls are acute
and significant, and set in quickly." Heart damage, which ultimately killed
singer Karen Carpenter, is the most common reason for hospitalization in most
people with anorexia.
Although the heart and the bones often take the brunt of the damage,
anorexia is a multisystem disease. Virtually no part of the body
escapes its effects. About half of all anorexics have low white-blood-cell
counts, and about a third are anemic. Both conditions can lower the immune
system's resistance to disease, leaving a person vulnerable to infections.
Anorexia Damage Starts Early
Even before a person with anorexia starts to look "too thin," these
medical consequences have begun.
Many young women who begin eating a severely restricted diet stop
menstruating well before serious weight loss sets in. Since so many people with
anorexia are teenage girls and young women, this can have long-term
consequences on their ability to bear children.
"In truly, fully recovered anorexics and bulimics, it looks like the
rate, frequency and number of pregnancies is normal," says Mickley.
"However, if you look at infertility clinics, and those patients in the
clinics who have infrequent or absent periods, the majority of them appear to
have occult eating disorders. They may think they're fully recovered, but they
haven't gotten their weight up high enough."
Many women with anorexia would rather seek fertility treatment than
treatment for their eating disorder, Mickley says. And even among women who
have fully recovered from their anorexia and bulimia, there may be a slightly
higher rate of miscarriages and caesarean sections. "There also may be up
to a 30% higher incidence of postpartum depression as compared to other
women," she says.