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All organs are affected by anorexia nervosa (AN) and starvation, some even resulting in anorexia organ damage. Severe malnutrition causes electrolyte disturbances and ultimately multi-organ failure. Nutrition, medical treatment and psychotherapy are the main therapies needed to insure a full and total recovery.
Anorexia nervosa can result in many different and simultaneous vitamin and mineral deficiencies as well as overall malnutrition. (1) These deficiencies can impact organ function and contribute to some of the serious medical complications that may result from AN. Eating an adequate quantity and variety of foods in recovery is essential to restoring these nutrients and enabling healing, though sometimes specific supplements may also be necessary to address deficiencies.
If you are struggling with anorexia nervosa, it is important to work with a supportive physician to assess whether anorexia organ damage has occurred, and to determine the best course of treatment. Different people’s bodies respond to restriction differently, and other factors, including the amount of time a person has had AN and whether they use purging behaviors or not, can influence how their organs are affected. Not every person will develop every possible complication associated with AN, however, this disorder should always be taken seriously and supportive medical care is important.
AN can cause the heart to shrink and result in abnormal electrical rhythms. (2) Many people with anorexia nervosa have a low heart rate and low blood pressure. These issues can be fatal, but are usually reversible with nutritional rehabilitation.
Brittle bones are a common and severe complication that can occur in those with anorexia nervosa. In some cases, bone density which is lost cannot be fully restored, though further loss can be prevented through improved nutritional status and restoration of hormone function. (3)
There is some evidence that certain medications, including teriparatide and denosumab, can help restore bone density in individuals with a history of AN, especially when used in combination. (4)
Many, but not all, people with anorexia nervosa who typically menstruate stop having a regular period during their eating disorder. Anorexia nervosa also tends to reduce libido, sex hormone levels, and sperm production. (5) With recovery and nutritional rehabilitation, menstruation and fertility usually returns, and those who have recovered from AN can typically have children if they want to.
Anorexia nervosa can result in a variety of GI problems, including delayed gastric emptying, acid reflux, constipation, bloating, nausea, and stomach pain. (6) Although GI distress may increase at the beginning of recovery as the body adjusts to increased food intake, these symptoms usually decrease as healing progresses. Some people will continue to have digestive issues after recovery. (7)
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These complications can be serious and should be closely monitored, especially at the beginning of recovery. Medical interventions may be needed to regulate electrolytes at the start of refeeding, but they will usually stabilize as recovery progresses.
Brain changes such as brain fog, loss of concentration, seizures, disordered thinking, and worsened anxiety and depression may result from anorexia nervosa. The brain loses mass due to starvation, a condition called cerebral atrophy. A SPECT scan can show the areas that need to be addressed to regain brain function. Studies show that the brains of those with anorexia nervosa process food, reward, hunger, and satiety differently than healthy people. (8,9)
In most cases, brain function and volume can be restored with nutritional rehabilitation and cognition improves.
The thyroid shuts down when someone has anorexia nervosa, showing low T3 levels and normal to below normal thyroid stimulating hormone levels. There are low levels of conversion of T4 to active T3 and increased conversion to inactive reverse T3. Malnutrition causes the thyroid to atrophy in anorexia nervosa. However, improvements are seen with nutritional rehabilitation. (9)
Many people with AN have persistently low blood sugar and depleted liver glycogen stores. AN can negatively impact liver functioning and in rare cases cause liver failure. Liver function generally returns to normal in recovery. (10)
While anorexia nervosa can result in many different types of organ damage and medical complications, most of these effects are reversible with recovery. It is never too late to reach out for support and begin the healing process.
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Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.
Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.
