What are the long term effects of anorexia nervosa?

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 begin to 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.³

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

Most people who lose their periods due to AN will begin to menstruate regularly again after they begin eating adequately and make progress in recovery. It is usually possible to get pregnant and give birth after recovering, but 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)

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3. Your GI tract

A variety of gastrointestinal 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 prior to dealing with their eating disorder. Most of these problems develop due to reduced energy availability causing digestion to slow down and the 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 a reduction in 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 to experience weakness, lack of energy, and fatigue.¹ There are multiple factors that 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 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 which 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 will be able to 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.