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Can eating disorders cause anemia?

Eating disorders like anorexia nervosa (AN) and bulimia nervosa (BN) are serious mental health conditions, but they cause a number of physical ailments, including anemia.

The overall malnutrition and specific vitamin and mineral deficiencies often brought on by AN and BN can lead to the development of certain types of anemia. Eating patterns and preferences practiced by people with eating disorders can further increase the likelihood of becoming anemic. 

Thankfully, treatment is available, both for eating disorders and the anemia that can be caused by them.

Last updated on 
September 12, 2023
September 12, 2023
In this article

What is anemia?

Anemia is a condition that occurs when there aren’t enough red blood cells in the body.

The job of the red blood cell is to help carry oxygen throughout the body, including to organs and muscles. When red blood cell counts are low, this could lead to feelings of fatigue, weakness, dizziness, and other, more serious, issues.8

Different types of anemia

Anemia can develop for a number of reasons, leading to different types of anemia, including:8,12,13,14

  • Iron deficiency anemia: Anemia that develops from low iron levels. The most common form of anemia, it can be caused by genetic conditions, dietary and lifestyle choices, gastrointestinal issues, blood loss, chronic kidney disease, and other chronic conditions that affect iron absorption.
  • Vitamin B-12-deficiency anemia: Anemia caused by low levels of B-12. The body requires B-12 to produce red blood cells, and lower levels of the vitamin lead to a lack of production or improperly developed red blood cells.
  • Hemolytic anemia: A blood condition that results in red blood cells being destroyed faster than they can be produced. It can be caused by certain autoimmune conditions, bone marrow failure, certain infections, and inherited conditions such as sickle cell disease.

Disordered eating habits involved in certain eating disorders may put someone at a higher risk for developing certain types of anemia.

Find out if remote eating disorder treatment will work for you
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Signs of anemia

There are a variety of physical symptoms associated with anemia, including:9

  • Tiredness
  • Weakness
  • Shortness of breath
  • Irregular heartbeat
  • Dizziness or lightheadedness
  • Pale or yellow skin
  • Cold hands and feet
  • Chest pain
  • Headaches

If you or a loved one are experiencing these symptoms, it may be time to visit a doctor.

Can an eating disorder cause anemia? 

It appears that the disordered behaviors involved with different eating disorders can, in many cases, lead to anemia.

One study looking at 921 patients with eating disorders found that anemia impacted many of the patients, including:3

  • 16.4% of patients with anorexia nervosa-restricting type
  • 20.2% of patients with anorexia nervosa, binge/purge type
  • 11.2% of patients with bulimia nervosa

Still, the unhelpful patterns involved in different eating disorders may bring about anemia in different ways.

Anorexia and anemia
Bulimia and anemia
Anemia and malnutrition

Treatment for anemia

Treatment for anemia is different, depending on the cause and severity of the condition.

Diet often plays an important role in rehabilitation for anemia, and nutritional therapy has been found effective at helping those with eating disorders like anorexia nervosa.10

Eating enough food and including adequate sources of dietary iron, in general, is an important part of recovering from both eating disorders and anemia. Some good food sources for iron include:11

  • Beans and lentils
  • Fortified cereals
  • Beef
  • Poultry
  • Spinach
  • Liver
  • Potatoes (with skin)
  • Nuts and seeds
  • Canned light tuna
  • Enriched rice or bread

Some people may also benefit from taking iron pills or other supplements, and medications can also be prescribed to help someone produce more red blood cells.8 For severe iron deficiency anemia, blood transfusions may be necessary.17

Finding help for an eating disorder

The good news when it comes to a serious mental health condition like an eating disorder is that help is available. Many different types of therapy have been developed to help people with eating disorders of all types, including AN, BN, binge eating disorder (BED), and other types of disordered eating.

When dealing with an eating disorder and anemia, it's always a good idea to work with a dietitian and health care team to create an individualized protocol based on your needs and symptoms.

Help is just a phone call away

At Within Health, we strive to help, putting patients in touch with a multidisciplinary treatment team that can address your unique needs.

If you or a loved one are struggling with an eating disorder, it's important to seek out help. Getting in touch with a caring medical professional is often the first step toward a healthier and happier future.

Get help today

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.


  1. Lemille, J., Le Bras, M., Fauconnier, M., & Grall-Bronnec, M. (2021). Anorexia nervosa: Abnormalities in hematological and biochemical parameters. La Revue de Medecine Interne, 42(8), 558–565.
  2. Gainhut, M., Godart, N., Benadjaoud, M. A., Melchior, J. C., Hanachi, M. (2021). Five-year mortality of severely malnourished patients with chronic anorexia nervosa admitted to a medical unit. AActa Psychiatrica Scandinavica, 143(2), 130-140.
  3. Walsh, K., Blalock, D.V., Mehler, P.S. (2020). Hematological findings in a large sample of patients with anorexia nervosa and bulimia nervosa. American Journal of Hematology, 95(4), E98-E101.
  4. Kaiafa, G., Kanellos, I., Savopoulos, C., Kakaletsis, N., Giannakoulas, G., & Hatzitolios, A. I. (2015). Is anemia a new cardiovascular risk factor? International Journal of Cardiology, 186, 117–124.
  5. Yilmaz, G., Shaikh, H. (2023). Normochromic Normocytic Anemia. Stat Pearls. Accessed September 2023. 
  6. Bredella, M. A., Fazeli, P. K., Miller, K. K., Misra, M., Torriani, M., Thomas, B. J., Ghomi, R. H., Rosen, C. J., & Klibanski, A. (2009). Increased bone marrow fat in anorexia nervosa. The Journal of clinical endocrinology and metabolism, 94(6), 2129–2136. 
  7. Wang, H., Leng, Y., & Gong, Y. (2018). Bone Marrow Fat and Hematopoiesis. Frontiers in Endocrinology, 9, 694.
  8. What is Anemia? (n.d.). National Heart, Lung, and Blood Institute. Accessed September 2023.
  9. Anemia. Mayo Clinic. Accessed September 2023. 
  10. Takeshima, M., Ishikawa, H., Kitadate, A., Saski, R., Kobayashi, T., Nanjyo, H., Kanbayashi, T., Shimizu, T. (2018). Anorexia nervosa-associated pancytopenia mimicking idiopathic aplastic anemia: a case report. BMC Psychiatry, 18, 150. 
  11. Iron. (n.d.). Harvard School of Public Health. Accessed September 2023. 
  12. Iron-Deficiency Anemia. (n.d.). National Heart, Lung, and Blood Institute. Accessed September 2023.
  13. Vitamin B12–Deficiency Anemia. (n.d.). National Heart, Lung, and Blood Institute. Accessed September 2023.
  14. Hemolytic Anemia. (n.d.). National Heart, Lung, and Blood Institute. Accessed September 2023.
  15. Lilenfeld, L. R., & Kaye, W. H. (1996). The Link Between Alcoholism and Eating Disorders. Alcohol Health and Research World, 20(2), 94–99.
  16. Salvia, M., Ritholz, M., Craigen, K.L.E., Quatromoni, P. (2022). Managing type 2 diabetes or prediabetes and binge eating disorder: a qualitative study of patients’ perceptions and lived experiences. Journal of Eating Disorders, 10, 148. 
  17. Iron-Deficiency Anemia. (n.d.). American Society of Hematology. Accessed September 2023.


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