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Mental health and physical medical complications of anorexia nervosa

Anorexia nervosa (AN) is a dangerous eating disorder that affects all facets of someone's life, with the complications of anorexia impacting not just the physical body but someone's psychological, emotional, and social well-being, as well.

AN may impact someone in ways that they may not even realize, but can be just as dangerous as the more apparent effects of the eating disorder. That's why it's important to understand all the potential complications of anorexia nervosa.

Spotting these issues can help you understand when a friend or loved one may be struggling with the condition. And getting them the help they need is an essential step toward helping someone overcome anorexia nervosa.

 minute read
Last updated on 
December 12, 2023
December 12, 2023
Anorexia complications
In this article

Physical effects of anorexia

Anorexia nervosa involves the severe restriction of food intake, leading to extreme weight loss and malnutrition, which can result in a wide range of physical complications.

Some of the most common physical effects experienced by patients with anorexia include:1,2,6

  • Fatigue and fainting
  • Slow or abnormal heart rate
  • Sudden cardiac death
  • Low blood pressure
  • Cuts or calluses on the hands from self-induced vomiting
  • Stomach cramps and other gastrointestinal issues
  • Muscle loss and weakness
  • Dehydration, or dry skin
  • Lanugo—a layer of downy hair all over the body to keep warm
  • Amenorrhea, or the loss of menstruation in people who usually get periods 
  • Loss of bone mineral density

It is important to note that the physical effects of anorexia nervosa can impact people of all body shapes and sizes, including those who are not at what is considered a "low" body weight. Not every person experiences all of the medical complications of AN either.

These physical complications can become increasingly severe over time and, if left untreated, can lead to death. Because of this, it is especially important for those suffering from AN to seek professional treatment involving a team of experienced professionals. 


Mental health complications of anorexia

Anorexia nervosa may have several physical complications, but it is ultimately a mental health disorder and is often tied to some co-occurring mental health disorders, including anxiety and depression.7 All together, these can create many additional difficulties.

Anorexia complications often start with chronic low self-esteem. It has been suggested that this characteristic is a prerequisite to developing any type of eating disorder.3

Often, these self-esteem issues manifest as a fixation on appearance, an intense fear of weight gain, and a distorted body image. These thoughts can go on to drive additional disordered behaviors, such as strict rituals around food, excessive exercise routines, and other measures taken to avoid gaining weight.1

As someone progresses with their disordered behavior, they may become fixated on it or ashamed of it, withdrawing from friends and loved ones, which can lead to greater social isolation.1 Unfortunately, in many cases, these mental complications of anorexia culminate in suicidality, with suicide accounting for the second-highest cause of death for those with AN.4

Social complications of anorexia nervosa

Individuals suffering from anorexia nervosa often find socializing difficult. AN disproportionately affects teens and young adults at a time in their lives when socialization is particularly important.5

Anxiety about eating in front of others, avoiding questions about weight or appearance changes, and respite from the self-imposed pressure of comparing themselves to others may all contribute to someone's retreat into isolation. 

Likewise, it can be difficult for someone with anorexia nervosa to maintain romantic relationships.

The anxiety connected to their body and appearance, the pressure to eat meals together, and the fear of intimacy—and opening up about all of these unhelpful thoughts and behaviors—may all cause social complications of anorexia.

Emotional anorexia complications

The emotional complications of anorexia may be caused by a combination of factors.

Diet plays a significant role in mood through its influence on hormone production.8 And the type of severely restricted diet that often accompanies anorexia nervosa may likewise impact someone's emotional state.

Some of the mental health complications of anorexia, such as the connection to depression and anxiety or the tendency to isolate, may also play a role in someone's emotional health.

All told, these factors may present as:1

  • Flat mood, or lack of emotion
  • Irritability
  • Mood swings
  • Anger
  • Rigidity in behaviors and extreme anxiety if those are disrupted

Like depression and anxiety, substance use disorders are common co-occurring disorders for people who struggle with AN.9 In these cases, the drugs and alcohol used by the individual often work to further the emotional wedge in their life, causing additional strain on outward relationships and self-esteem.

Finding help for anorexia nervosa

Anorexia nervosa medical complications can be dangerous or even deadly if left untreated. That's why, if you or a loved one are struggling with this mental illness, it's so important to find help.

Appropriate treatment for AN should address all of the ways that the disorder impacts an individual, including the physical, mental, social, and emotional complications of anorexia. A combination of nutritional counseling to encourage healthy weight restoration and mental health therapy to help address the emotional and mental health challenges should be involved.

Learn more about remote treatment

At Within, we believe in addressing a whole person in eating disorder recovery rather than focusing on symptoms. Our team of multidisciplinary experts will create a tailored treatment plan for each individual based on their specific needs and history. And together, we'll work to restore someone to a sense of healthiness and happiness.

Get help today

Recovery from eating disorders like anorexia nervosa may feel difficult or even impossible, but help is always available, and healing is always an option.

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. Anorexia nervosa. (2018, February 28). National Eating Disorders Association. Accessed October 2023.
  2. Misra, M., & Klibanski, A. (2011). Bone health in anorexia nervosa. Current Opinion in Endocrinology, Diabetes, and Obesity, 18(6), 376–382.
  3. Silverstone, P. H. (1992). Is chronic low self-esteem the cause of eating disorders? Medical Hypotheses, 39(4), 311–315.
  4. Smith, A. R., Zuromski, K. L., & Dodd, D. R. (2018). Eating disorders and suicidality: what we know, what we don't know, and suggestions for future research. Current Opinion in Psychology, 22, 63–67.
  5. Eating disorders (young people) - Social life and public places. (2022). Health Talk. Accessed October 2023.
  6. Jáuregui-Garrido, B., & Jáuregui-Lobera, I. (2012). Sudden death in eating disorders. Vascular Health and Risk Management, 8, 91–98.
  7. Salbach-Andrea, H., Lenz, K., Simmendinger, N., Klinkowski, N., et. al. (2008). Psychiatric Comorbidities among Female Adolescents with Anorexia Nervosa. Child Psychiatry and Human Development, 39, 261-272. 
  8. Firth, J., Gangwisch, J. E., Borisini, A., Wootton, R. E., & Mayer, E. A. (2020). Food and mood: how do diet and nutrition affect mental wellbeing? BMJ, 369, m2382.
  9. Eskander, N., Chakrapani, S., & Ghani, M. R. (2020). The Risk of Substance Use Among Adolescents and Adults With Eating Disorders. Cureus, 12(9), e10309.


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