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.
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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
The anemia that often occurs with AN is called normochromic normocytic anemia. That means that blood cells are considered a normal size and color, with the problem coming from a lack of these cells.5
Generally, low levels of normal red blood cells are traits of iron deficiency or B-12 deficiency anemia, which can also be brought about by dietary choices, including food and fluid restriction.
In any case, anemia can become severe in people with a serious eating disorder like AN, potentially resulting in the heart not getting enough oxygen due to insufficient levels of red blood cells.1 In these cases, the body may compensate by pumping blood faster, which can, in turn, increase risk of heart attack.4
In fact, anorexia nervosa has one of the highest mortality rates of any psychiatric disorder, and the development or co-occurrence of anemia with AN is one of the most significant predictors of mortality in people struggling with the disorder.2
Bulimia and anemia
Bulimia nervosa and anemia also frequently occur together.
The binging and purging patterns involved in BN often bring about vitamin and mineral deficiencies and other forms of malnutrition. Again, these types of deficiencies usually point to iron deficiency or B-12 deficiency anemia.
With B-12 deficiency anemia specifically, alcohol consumption and diabetes can also present as risk factors. People with BN have been found to have high rates of alcohol use disorder, and binge eating—a key aspect of BN—has also been associated with diabetes.13,15,16
Anemia and malnutrition
Eating disorders of all kinds can
lead to malnutrition, and, in many cases, malnutrition can also lead to anemia.
One of the biggest impacts of malnutrition on the human body is on bone marrow. Issues like iron deficiencies and other vitamin and mineral shortages can cause bone marrow to become more fatty than usual. As red blood cells are manufactured in bone marrow, this change to the environment can lead to certain types of anemia.
6,7
Another type of anemia, called pancytopenia, occurs when blood cells of all types—including white blood cells, red blood cells, and platelets—are lower than they should be. This issue commonly occurs in people with anorexia nervosa.
10
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.
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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.
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