Eating disorders (EDs) are insidiously destroying some lives and greatly restricting others. However, eating in secret and feeling guilt are not the only consequences of having an eating disorder. There is a myriad of other health problems that develop as a result.
In this, the second piece in the series on eating disorders, we shall explore together the effects on the health of those living with disordered eating.
The Risk Factors For Forming an Eating Disorder
Today we are bombarded with messages telling us that dieting, and exercise, are good for us and will make us live longer. While there is no denying that this is true when done in moderation to improve health, what happens when something goes wrong and the drive to be healthy becomes something else altogether?
There are many risk factors that may cause an eating disorder to form, including:
Having a close relative with an eating disorder. Research has discovered that eating disorders are closely related to genetic mutations that are inheritable and passed from parent to child.
Having a history of see-saw dieting. Losing and gaining significant amounts of weight can also be a risk factor because the person may eventually fall into disordered eating.
Having type I (insulin-dependent) diabetes. Research has discovered that around one-fourth of women diagnosed with type one diabetes will develop an eating disorder. The most common is called diabulimia which involves skipping insulin injections. Missing insulin injections can be deadly.
Being a perfectionist. An incredibly strong risk factor for forming an ED is having self-oriented perfectionism. This disorder involves setting unrealistic expectations of oneself which can lead to disgust for oneself which in turn drives an eating disorder.
Dissatisfaction with one’s body. While all of us are dissatisfied with how our body looks at times, people with eating disorders have a warped sense that their body is ugly.
History of an anxiety disorder. Having an anxiety disorder can be a driving force behind forming an eating disorder because of the sense of being out of control. An eating disorder offers a person who feels out of control an area in their lives where they feel they are in control.
Body Dysmorphism. Body dysmorphism is a mental health disorder where the person cannot stop thinking about perceived defects and flaws in their appearance. A perceived flaw, such as noticing weight gain in a mirror, can cause great distress even though the gain is normal and isn’t easily noticed by others. The embarrassment, shame, anxiety, and self-loathing are tragically debilitating and a driving force behind forming an eating disorder.
History of being bullied. Children who are bullied about the way they look, and their weight, grow into adults who feel self-loathing for their own bodies. This self-loathing can easily become the catalyst for an eating disorder.
The Bombardment by society of the “perfect body” image. Everywhere one turns there are magazines, television programs, and advertisements promoting the “perfect body” that can be gained if one will purchase or follow this diet or use that gadget. Society seems to be centered on the “perfect weight” and the “perfect image”. People who have eating disorders are often attempting to force themselves into the unrealistic mold societal forces have sold them.
A history of trauma. Having a trauma history is an enormous stimulus to forming an eating disorder, especially if the trauma involved sexual abuse. Survivors of childhood trauma or trauma in adulthood such as a sexual assault may drive the person to attempt to exert control over their bodies as a response to the helplessness they felt during the traumatic event.
The above list is not all-inclusive as there are many other risk factors for forming an eating disorder.
The Physical Causes of Eating Disorders
The mechanisms of what causes eating disorders are not well-understood, however, there are indications that genetic and biological problems are highly responsible for forming an ED.
Genetics. One such factor is linked genetically. Genetics are known to play a vital role in the formation of an increasing the likelihood of forming one 50–80% (Lutter, et. al. 2017). In fact, Lutter et. al. found that having an ultra-rare genetic mutation drastically increases forming an eating disorder.
Biological. Changes in brain chemicals also may play a role in eating disorders. Some of these changes involve the neurotransmitters dopamine and serotonin.
Dopamine is known as the pleasure chemical and it helps humans by allowing them to feel satisfaction and joy. However, anorexia has been associated with an over-production of dopamine that leads to anxiety, and the ability to do unpleasant things such as not eating. Dopamine is also indicated as a culprit in the other eating disorders as well (Broft et. al., 2012) (Bello & Hainal, 2010).
Serotonin is responsible for, other things, mood, sleep, and feeling hungry. Research has discovered that people currently in the throes of anorexia nervosa have significantly lower levels of serotonin in their cerebrospinal fluid than those who do not (Kaye et. al., 1991).
A Breakdown of the Health Effects from Eating Disorders
The health effects of eating disorders are not as one might think, in the positive. After all, we are bombarded with messages telling us that exercise and weight loss will help us live longer. However, in eating disorders, this message becomes distorted in the minds of those who form them.
Eating disorders have many dire consequences to the body including gastrointestinal, neurological, endocrine, cardiovascular, and mortality changes.
Vomiting. Vomiting can wear down the esophagus or cause it to rupture which is a life-threatening occurrence. Vomiting can also lead to less threatening symptoms such as chronically sore throats and hoarseness. Both vomiting and abuse of laxatives will cause dehydration that can become serious if not enough fluids are drunk to replace those lost.
Gastroparesis. Gastroparesis means slowed digestion which can be caused by food restriction or purging via vomiting which interferes with stomach emptying and the absorption of nutrients. Gastroparesis can lead to stomach pain and bloating, blood sugar fluctuations, malnutrition, and a blocked intestine which is a life-threatening emergency.
Perforation and Rupture. Binge eating can cause a perforation of the bowel or stomach rupture Both are life-threatening conditions.
Nerve Damage. Abusing laxatives may damage the nerve endings in the bowels leaving them totally dependent on laxatives to evacuate feces from the body.
Pancreatitis. Inflammation of the pancreas is a serious side-effect of having an eating disorder. Pancreatitis is extremely painful and if not caught and treated early, it can lead to systemic infection and can be fatal.
Obsessions and Loss of Concentration. Dieting, fasting, and starvation leave the brain without enough energy leading to obsessions about food and difficulties with concentrating. These effects happen because the brain consumes up to one-fifth of the calories taken in and used by the human body.
Neuron Disconnections. Neurons, also known as brain cells, require insulation around them called myelin. Without myelin, the electrical signals from neuron to neuron is cut off or at least greatly restricted. Without adequate ingestion of fats in the diet, the insulation cannot form or be healthy when it does. This damage leads to numbness, tingling, and perhaps long-term neural damage.
Neurons also require electrolytes such as sodium, potassium, calcium, and chloride to send signals from the brain to the body. Dehydration from vomiting or diarrhea causes an imbalance in electrolytes that can lead to muscle cramps and seizures.
Endocrine System Changes
Falling Hormone Levels. The human body needs hormones to function in many areas. Without enough intake of fat and calories, hormone levels fall. These hormones include; estrogen, testosterone (aka sex hormones), and thyroxine (the list is not all-inclusive).
A fall in sex hormones will cause menstruation to begin, become irregular or stop altogether. Also, a lowered level of sex hormones will significantly increase the risk of bone loss (osteoporosis) and the risk of breaking or fracturing a bone.
Type 2 Diabetes. Binge eating can increase the chances that a person’s body will become resistant to insulin because insulin is dependent on carbohydrates to give the body energy.
Hypothermia. Without enough energy, core body temperature will drop leading to hypothermia (not enough body heat).
High Cholesterol. Starvation causes high cholesterol levels.
Heart Failure. Eating too few calories means the body must breakdown its own tissues for fuel and muscles are some of the first organs to go. The most important muscle in the body is the heart. As the body digests the heart for fuel, it prevents the heart from pumping correctly resulting in lowered blood pressure and less circulation. Slowly the heart dies until heart failure results.
Purging by using vomiting or abusing laxatives depletes the body of electrolytes (see above). Potassium is vital in helping the heart to beat by aiding it in contracting. However, when one purges food they lose electrolytes causing the heart to fail. It is vital to note that drinking excessive amounts of fluids will also result in heart failure via the loss of electrolytes through urination.
Increased Risk of Death
Every 62 minutes one person dies from complications caused by an eating disorder. Did that surprise you?
Here are some more shocking statistics:
1 in 5 people living with anorexia nervosa die by suicide.
1 in 25 people living with bulimia nervosa die by suicide.
The National Death Index of the United States reports that:
The mortality rate for anorexia nervosa stands at 4% of those afflicted.
The mortality rate for bulimia nervosa is 3.9%.
The mortality rate for eating disorders not otherwise specified is 5.2%.
The bottom line, eating disorders can be killers.
Some Hope-Filled Words
The suffering caused by all types of eating disorders is beyond measure. However, one does not need to become a statistic. By seeking and getting the proper help, many people have overcome the challenges of eating disorders and gone on to live healthy and productive lives.
The first step to surviving and thriving after an eating disorder has formed is to recognize and admit to yourself that you have disordered eating patterns. The next step is to reach out to someone who can help.
Having a mental health condition such as an eating disorder is not be a death sentence. Remember that.
“Life is a journey and it’s about growing and changing and coming to terms with who and what you are and loving who and what you are.”~ Kelly McGillis
“We are cups, constantly and quietly being filled. The trick is, knowing how to tip ourselves over and let the beautiful stuff out.” ~ Ray Bradbury
Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders: a meta-analysis of 36 studies. Archives of general psychiatry, 68(7), 724–731.
Bello, N. T., & Hajnal, A. (2010). Dopamine and binge eating behaviors. Pharmacology Biochemistry and Behavior, 97(1), 25–33. DOI: 10.1016/j.pbb.2010.04.016
Broft, A., Shingleton, R., Kaufman, J., Liu, F., Kumar, D., Slifstein, M., … & Walsh, B. T. (2012). Striatal dopamine in bulimia nervosa: A pet imaging study. International Journal of Eating Disorders, 45(5), 648–656. DOI: 10.1002/eat.20984
Kaye, W. H., Gwirtsman, H. E., George, D. T., & Ebert, M. H. (1991). Altered serotonin activity in anorexia nervosa after long-term weight restoration: does elevated cerebrospinal fluid 5-hydroxyindoleacetic acid level correlate with rigid and obsessive behavior? Archives of General Psychiatry, 48(6), 556. DOI: 10.1001/archpsyc.1991.01810300068010
Lutter, M., Bahl, E., Hannah, C., Hofammann, D., Summer, A., Cui, H., McAdams, C.J., Michaelson, J. J., (2017). Novel and ultra-rare damaging variants in neuropeptide signaling are associated with disordered eating behaviors. PLOS ONE. DOI:10.1371/journal.pone.0181556