Anorexia: The Body Neglected
What, exactly, does anorexia nervosa do inside the human body? The heart and bones suffer the most.
The Risks of Bulimia
Bulimia, which often goes hand in hand with anorexia, does its own unique
health damage. Bulimics who purge by vomiting wreak havoc on their digestive
tracts by chronically bathing them in stomach acid, which can lead to digestive
disorders like reflux esophagitis.
"It feels like I've been drinking Draino," said one woman who posted
to a forum on digestive diseases about the consequences of her lifelong
anorexia and bulimia. Some reported cases suggest bulimia may have led to a
condition called Barrett's esophagus, which may can lead to esophageal
Damage from Anorexia May Be Reversible
The good news: Many of these complications can be reversible -- if the
person returns to a normal weight. "The real focus has to be on weight
restoration if you want to reverse outcomes," says Rebecka Peebles, MD, a
specialist in adolescent medicine at the Lucile Packard Children's Hospital in
Palo Alto, Calif. "That's the most essential part of treatment. You can't
wait around for it to happen. It really is an essential first step in treatment
Unfortunately, say experts, too many people believe that anorexia is
strictly a psychological disorder, and ignore its medical complications unless
the patient becomes visibly, dangerously thin. "A lot of people -- parents,
and even some doctors -- think that medical complications of anorexia only
happen when you're so thin you're wasting away," says Peebles.
"Practitioners need to understand that a good therapist is only part of the
treatment for anorexia and other eating disorders, and that these patients need
treatment from a medical doctor as well."
Studies have found that many people who need treatment for anorexia aren't
getting it. In large part, this may be due to cost. Inpatient treatment can
cost more than $30,000 per month, while outpatient treatment can run as much as
$100,000 per year.
Melissa Román, a Miami woman
who's been in recovery from anorexia for several years, pays $800 per month out
of pocket for therapy sessions that insurance won't cover. According to the
National Eating Disorders Coalition, health insurance companies pay for an
average of 10 to 15 treatment sessions for people with eating disorders, when
more long-term care -- as many as 40 sessions -- may be needed for true
"Access to care is a huge issue," says Mickley. "Eating
disorders aren't staged the way cancer is, so we don't have the way to convince
insurance companies that a low potassium level can be like a small metastasis.
It's only recently that we've begun to understand the genetic and neurochemical basis of
anorexia and say that this is a real illness, not a whim of spoiled rich girls.
It's been treated like it's voluntary and willful as opposed to what it is: a
serious, life-threatening psychiatric and medical illness."