How Disordered Eating Harms Your Body Experts Tackle Eating Disorder Health Hazards

Starving and bingeing and purging may start as misguided attempts at weight loss, but they lead to serious health problems. To mark Eating Disorders Awareness Week, read on to learn how anorexia, bulimia and other disordered eating problems can hurt the body... Christine Harrison is only 28, but she already has osteoporosis. “I’ve had anorexia and bulimia for 13 years, and they’ve made my bones as weak as those of an 80-year-old woman,” she says. Christine, whose weight has yo-yoed between 55 and 130 pounds on her 5-foot frame, was in and out of eating-disorder institutions since age 15. Now a college grad, she has a fulfilling career working with special-needs children at a psychiatric facility in Massachusetts. But recently, her eating disorder spiraled out of control again, and she has become too thin and frail to do much of anything. About 7 million women suffer from eating disorders such as anorexia, characterized by self-starvation, and bulimia, which involves binge-eating and purging afterward. For them, disordered eating isn’t only about a desire to lose weight. The root is complex, a combination of biological and psychological factors, according to the National Eating Disorders Association. “An eating disorder isn’t just about food – it’s a serious psychiatric and physiological disorder that can have life-threatening consequences,” says Kenneth L. Weiner, M.D., assistant clinical professor of psychiatry at the University of Colorado Medical Center and co-founder and CEO of the Eating Recovery Center in Denver. That’s because one consequence of an eating disorder – malnutrition – “deprives organs of nutrients they need for virtually every bodily function,” says James Greenblatt, M.D., medical director of Comprehensive Psychiatric Resources in Waltham, Mass., and author of Answers to Anorexia (Sunrise River Press). For example, “many women with eating disorders shun meat and dairy products to save calories and fat and wind up developing a vitamin B12 deficiency, which causes depression, anxiety, paranoia and memory problems,” he says. Also, women who repeatedly force themselves to vomit and abuse laxatives and/or diuretics also may have lower levels of electrolytes (important minerals such as potassium, sodium and chloride), leading to serious heart and kidney problems, Greenblatt explains. Read on for the top 5 ways disordered eating damages your health. 1. No menstrual cycle Your body needs healthy levels of calories, fat and protein to prepare it to carry a baby. With an eating disorder, however, you don’t eat enough nutrients to support yourself, much less a baby, says Rebecca Appleman, R.D., a nutritionist at Columbus Park Collaborative, a private outpatient treatment center in New York City. So to prevent pregnancy, your body shuts down its reproductive cycle and stops menstruation, a condition called amenorrhea, she says. Eating disorder treatment: In most cases, you can reverse the danger and damage by gaining weight and eating a healthy diet. “Just don’t try to fix things yourself,” Weiner advises. “The fastest and safest way to recovery is a residential or outpatient eating disorders clinic where a team of professionals [for example, nutritionists, psychologists, psychiatrists, fitness professionals, bone specialists and ob-gyns] can address every aspect of your disease.” 2. Weak bones “Amenorrhea causes estrogen levels to plummet, [which] increases bone loss,” says Felicia Cosman, M.D., clinical director of the National Osteoporosis Foundation and medical director at the Clinical Research Center of Helen Hayes Hospital in West Haverstraw, N.Y. That’s because estrogen protects bone by suppressing the action of osteoclasts, cells that break down bone. Without sufficient estrogen, osteoclasts go into overdrive, accelerating bone loss faster than the body can build it up again, according to a 2011 Polish study conducted at Poznan University of Medical Sciences. Women with disordered eating problems are also depriving their bodies of nutrients critical for bone development, including: Bone-protective calcium. “Many of the biggest ‘fear foods’ among women with eating disorders are dairy foods that are high in calories and saturated fat, but which contain the most calcium,” says dietitian Jodi Krumholz, L.D.N., director of nutrition at the Renfrew Center of Florida in Coconut Creek. Vitamin D and healthy fats. “Calcium can’t be absorbed without vitamin D, and it can’t be circulated in your body unless you eat food that contains fats,” Appleman says. As a result, “92% of women with anorexia have osteopenia and 40% have osteoporosis,” Weiner says. With osteopenia, bones are less dense than normal. In osteoporosis, bones may be so weak that a sneeze could lead to a fracture, Cosman warns. Most of the bodily harm from eating disorders can be repaired, but not bone health. That’s especially true for young women, who comprise more than 90% of those with disordered eating problems, according to the National Institute of Mental Health. “Adolescence is the body’s prime bone-building time,” Weiner says. “If you starve your body of vital nutrients, you lose bone instead of building it, and your bones never catch up.” Statistics back him up: “Eighty-five percent of partially recovered anorexics still have bone mineral deficiencies,” Krumholz adds. Eating disorder treatment: Work with a nutritionist to eat a healthy diet that contains about 2,000 daily calories and plenty of bone-building nutrients, including calcium and vitamin D, Cosman advises. The Institute of Medicine recommends 1,000 mg of calcium daily if you’re younger than 50 and 1,200 mg if you’re 50 or older. The recommended daily allowance (RDA) for vitamin D is 600 IU (International Units) for women younger than 70 and 800 IU for women 70 and older. But some experts recommend you take more, especially if you have an eating disorder. “To maximize calcium absorption, get at least 2,000-3,000 IU daily,” says Michael Holick, M.D., Ph.D, a professor of medicine at Boston University Medical Center and author of The Vitamin D Solution (Penguin). Also, “eat plenty of healthy fats, including polyunsaturated fats [found in safflower, corn, sunflower, soy and cottonseed oils, nuts and seeds], monounsaturated fats [found in olive oil, peanut oil, canola oil, avocados, nuts and seeds] and omega-3 fatty acids [found in fatty, cold-water fish like salmon, tuna, mackerel and herring, flaxseeds, flax oil and walnuts],” Appleman says. Another bone preservation tip: Don’t overdo rigorous exercise until you’re close to your ideal weight, Weiner says. Moderate exercise and weight training can help preserve bone, but more than eight hours of rigorous exercise weekly can trigger amenorrhea and bone loss, according to the National Institutes of Health. 3. Heart disease Ninety-five percent of women with anorexia had irregular heartbeats that could lead to heart disease or heart attacks, according to a 2011 study conducted at Rutgers University. The risk of heart disease is so great that women with eating disorders have the highest mortality rate of all women with psychiatric diseases, a 2006 study at New York’s Montefiore Medical Center found. That’s because vomiting, and abusing laxatives and diuretics, can lead to dangerously low levels of electrolytes, which are needed to maintain a healthy heartbeat and blood pressure, says Shalizeh Shokooh, M.D., a cardiologist and co-medical director of the Women's Heart Center at St. Joseph Hospital in Orange, Calif. In addition, many women with eating disorders lose excessive amounts of body fat, which can lead to extremely low blood pressure and body temperature – problems that can cause an irregular heartbeat, a heart attack, even sudden death, Greenblatt says. Also, eating disorders can trigger physical changes in the heart, such as mitral valve prolapse, a potentially life-threatening condition that prevents the valve that separates the upper and lower chambers of the left side of the heart from closing, according to a 2003 study at Italy’s Florence University School of Medicine. Eating disorder treatment: “Gaining weight, eating a healthy diet and [not vomiting, starving, abusing laxatives and diuretics] can all help reverse heart damage caused by eating disorders,” Greenblatt says. “If you’ve had an eating disorder for more than a few months, get your potassium levels measured regularly [with blood and urine tests] and make sure you eat a diet rich in potassium,” he adds. The RDA for potassium is 4,700 mg daily. Foods rich in potassium include avocados, dried fruit such as apricots and dates, beans, flaxseed, pistachios, salmon, tuna, paprika, cocoa powder and chocolate. 4. Kidney disease The kidneys remove toxins and maintain a proper balance of water and potassium in your body. But if you vomit or abuse laxatives or diuretics, your potassium levels could fall to dangerously low levels, warns Jessica Bartfield, M.D., an internist who specializes in weight management at Loyola University’s Gottlieb Memorial Hospital outside of Chicago. This could lead to dehydration and low blood pressure – which alone or together could cause kidney infection. That, in turn, could increase the risk of kidney damage or even failure, she says. As much as 40% of women with eating disorders have dangerously low potassium levels, according to a 2011 study conducted at the Kidney Institute at China Medical University Hospital in Taiwan. Eating disorder treatment: “Get your potassium levels tested regularly, refrain from disordered eating behaviors and eat a potassium-rich diet to correct deficiencies,” Greenblatt says. 5. Indigestion Starving, vomiting and abusing laxatives and diuretics deplete enzymes needed to digest food and absorb nutrients, Greenblatt says. Such practices cause serious electrolyte imbalances, which increase or decrease bowel activity, triggering cramps, bloating, flatulence, constipation and diarrhea, he says. Chronic vomiting also can tear the esophagus and even rupture the stomach, he says. Eating disorder treatment: If you have an eating disorder, a simple urine test can detect deficiencies in digestive enzymes, Greenblatt says. If you have deficiencies, work with your physician and a dietitian to eat healthy foods and take probiotics to aid digestion. For more information on eating disorders, visit: The Eating Disorder Foundation National Eating Disorders Association National Association of Anorexia Nervosa and Associated Disorders For more information and expert advice, visit our Mental Health Center. Do You Have an Eating Disorder? In today's thin-obsessed society, it's hard to feel confident about your body. You may overindulge in junk foods, or you may often feel ashamed of your weight. Everyone has insecurities, but these insecurities can lead some people to develop a negative relationship with food. Are your eating habits normal, or are you on the road to an eating disorder?