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What are the long term effects of anorexia nervosa?

In individuals with anorexia nervosa (AN), some may experience its effects in the long term.

Some of those effects include low blood pressure, anemia, poor circulation, gastrointestinal (GI) problems, and more. It is important to understand how anorexia might be contributing to these difficulties.

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 minute read
Last updated on 
June 10, 2024
June 10, 2024
Long-term effects of anorexia
In this article

1. Heart and blood vessels

With anorexia nervosa, some people may experience an irregular heartbeat, slow heart rate, and low blood pressure. In addition, some may experience poor circulation, anemia, and a constant feeling of being cold.1,2 

When the body is starving, it will eventually break down muscle tissue, including cardiac muscle, which makes up the heart.2 This contributes to high rates of cardiac problems and sudden cardiac death in people with AN.

Learn how eating disorders affect the heart
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2. Loss of menstrual cycle and fertility

For those who menstruate, absent or irregular periods often result from anorexia nervosa.2,3 This occurs due to hormonal changes and the body’s attempts to conserve energy while experiencing malnutrition. It is important to note that some people with AN will continue having periods while engaging in severe eating disorder behaviors, and this is no longer part of the DSM criteria for an anorexia nervosa diagnosis.4

WAnorexia isn’t the only type of eating disorder that can affect menstruation. Find out how bulimia nervosa and harmful eating habits can also impact your period.

Most people who lose their periods due to AN will begin to menstruate regularly again after they begin eating adequately and making progress in recovery. It is usually possible to get pregnant and give birth after recovering. Still, challenges with conception and pregnancy complications are more common in people with a history of AN than those without.2 Some people may also experience an irreversible loss of fertility due to suffering from AN. 

People who do not menstruate can also experience significant hormonal disruptions,3 including low testosterone and reduced bone density as a result of anorexia nervosa. In people of all genders, loss of bone mineral density due to hormonal changes from malnutrition can lead to osteoporosis, which may be irreversible.2


3. Your GI tract

A variety of gastrointestinal medical complications can result from anorexia nervosa, including constipation, gastroparesis, liver disease, bloating, abdominal pain, and stomach ulcers.3 In addition, someone with anorexia nervosa may already have GI issues before dealing with their eating disorder. Most of these problems develop due to reduced energy availability, causing digestion to slow down and causing a lack of nutrients necessary for cellular functions and repairs. 

Many people in recovery from AN experience digestive issues during the refeeding and recovery process as the body adjusts to processing more food and restoring digestive speed and function.5 Most people will experience reduced digestive issues as they continue to eat consistently and adequately and their bodies readjust. In some cases, digestive problems may persist after recovery.5

4. Weakness, lack of energy, and fatigue

It is common for people with anorexia nervosa (and disordered eating habits in general) to experience weakness, lack of energy, and fatigue.1 Multiple factors can contribute to this, including anemia, vitamin deficiencies, overall inadequate energy intake (resulting in decreased metabolic rate), low body weight, and breakdown of muscle tissue during starvation.3

Eating disorder treatment is available

Using a multi-disciplinary perspective approach is one of the best things you can do to recover from anorexia nervosa and reverse as many of the long-term effects as possible. If you are able, it is beneficial to work with a team made up of dietitians, psychologists, and physicians who focus on helping those with anorexia and other eating disorders and who will work with you to navigate the mental and physical health effects of the eating disorder.

Working with a multidisciplinary anorexia treatment team can help to identify specific nutritional deficiencies and other abnormal lab values that may be contributing to symptoms of a serious eating disorder. While vitamins and other supplements can be a helpful piece of treatment, increasing strength and energy is dependent on your food intake. You need to eat enough food to meet the body's needs, restore metabolic functions, and enable cellular damage that occurs during the eating disorder to be repaired.6,7 This is all part of weight restoration and learning to be ok with gaining weight.

In cases of severe anorexia nervosa, inpatient treatment options should be considered. Your treatment team can advise you of the best course of action.

Support groups

The mental health community is broad and can be extremely helpful when recovering from an eating disorder.

There may be long-term effects of anorexia after recovery, but healing is possible. Reaching out for support can be an important first step to recovering from this disorder.

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. Giovinazzo, S., Sukkar, S. G., Rosa, G. M., Zappi, A., Bezante, G. P., Balbi, M., & Brunelli, C. (2019). Anorexia nervosa and heart disease: a systematic review. Eating and weight disorders, 24(2), 199–207. 
  2. Ekern, B. (2021, February 18). Long term & short term consequences of anorexia. Eating Disorder Hope. Retrieved August 16, 2022.
  3. Cost, J., Krantz, M. J., & Mehler, P. S. (2020, June 1). Medical complications of anorexia nervosa. Cleveland Clinic Journal of Medicine. Retrieved August 16, 2022.
  4. Table 19, DSM-IV to DSM-5 anorexia nervosa comparison - DSM-5 changes. (n.d.). Retrieved August 16, 2022.
  5. Mack, I., Cuntz, U., Grämer, C., Niedermaier, S., Pohl, C., Schwiertz, A., Zimmermann, K., Zipfel, S., Enck, P., & Penders, J. (2016, May 27). Weight gain in anorexia nervosa does not ameliorate the faecal microbiota, branched chain fatty acid profiles and gastrointestinal complaints. Nature News. Retrieved August 16, 2022.
  6. Castro, J., Deulofeu, R., Gila, A., Puig, J., & Toro, J. (2004). Persistence of nutritional deficiencies after short-term weight recovery in adolescents with anorexia nervosa. International Journal of Eating Disorders, 35(2), 169–178. 
  7. Eating Disorders. (n.d.). National Institute of Mental Health. Retrieved March 30, 2023.
  8. Meczekalski, B., Podfigurna-Stopa, A., & Katulski, K. (2013). Long-term consequences of anorexia nervosa. Maturitas, 75(3), 215–220.
  9. Titova, O. E., Hjorth, O. C., Schiöth, H. B., & Brooks, S. J. (2013). Anorexia nervosa is linked to reduced brain structure in reward and somatosensory regions: a meta-analysis of VBM studies. BMC Psychiatry, 13, 110.
  10. Wentz, E., Dobrescu, S. R., Dinkler, L., Gillberg, C., Gillberg, C., Blennow, K., Råstam, M., & Zetterberg, H. (2021). Thirty years after anorexia nervosa onset, serum neurofilament light chain protein concentration indicates neuronal injury. European Child & Adolescent Psychiatry, 30(12), 1907–1915.


What are the long-term effects of anorexia after recovery?

Thankfully, many of the health complications associated with anorexia nervosa subside once weight and eating behaviors have returned to normal. However, some symptoms of AN may persist even after recovery.

Damage to teeth can be permanent, requiring more intensive treatments such as oral surgery to correct. 

AN can also lead to long-term issues with bone health, as the condition is often connected to decreased bone mineral density (BMD). This can result in a higher likelihood of spontaneous fractures and a higher risk of developing osteopenia and osteoporosis, even after recovery.8

Several long-term complications can also show up during pregnancy, including issues with weight gain and fetal growth and higher rates of hyperemesis gravidarum, anemia, and obstetric complications.8

What are the long-term effects of anorexia on the brain?

Anorexia nervosa has been found to have an impact on the brain, including reductions in white and gray matter and an increase in cerebrospinal liquid, among other changes.9 However, studies on the long-term effects of AN on the brain are less forthcoming.

One study examined women 30 years after receiving their initial AN diagnosis. It suggested that there may be a correlation between AN and long-term risk of brain injury, though more data was called for to support this finding.10

Further reading

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Can you have mild anorexia?

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Further reading

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