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(10) Anorexia

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Anorexia - Caitlyn's Journey

anorexia

Is anorexia dangerous? What are the risks associated with anorexia?

Yes. Anorexia can be very dangerous. Indeed, the most serious physical risk associated with the illness is death.

In fact, anorexia has the highest premature death rate of any mental illness, with estimates of fatality occurring in 5–20% of cases (the aggregate death rate is estimated at 0.56% per year or 5.6% per decade). The American Journal of Psychiatry reported that for female anorexia patients between the ages 15–24, the fatality rate associated with the illness is twelve times higher than all other causes of death. In addition, the suicide rate for people with anorexia is reportedly up to 50 times higher than

in the general population. Most often, the cause of death for someone with anorexia is either from the physical complications of starvation or from suicide, and studies show that the risk of death from anorexia increases the longer one has had the illness. In addition, co-occurring psychiatric conditions (such as depression), substance abuse, and a high frequency of binge–purge behavior have been associated with increased risk of fatality.

Numerous additional medical complications can occur in patients with anorexia, many of which are the result of malnutrition. Many of these medical complications can be quite serious, though some can be reversed through proper medical treatment and nutritional rehabilitation. Physical recovery, just like psychological recovery, can take a substantial amount of time, so it is important to consult a physician as soon as a problem is suspected and to include a medical doctor in the recovery process. Including a doctor is particularly important because certain medical illnesses can mimic many of the symptoms of anorexia. With a thorough examination, your doctor will be able to rule out other medical causes of symptoms resulting from a different diagnosis or condition. In the following paragraphs, you will find descriptions of some of the medical complications associated with anorexia.

 Heart Problems Self-starvation and the malnutrition caused by anorexia can have serious effects on one’s heart and circulatory system. The malnourished heart muscle becomes weaker and may even shrink in size. Dehydration that results from purging or starvation

can cause an imbalance of electrolytes, which may lead to an irregular heartbeat. In severe cases, cardiac arrhythmia can put a patient at greater risk for a heart attack.

Gastrointestinal Problems

Complications from anorexia can manifest in any part of the digestive system. Swollen glands, acid-reflux, and lesions in the esophagus can result from purging. Constipation is common with food restrictions. Gastroparesis can cause bloating, nausea, abdominal pain, and vomiting. The liver can develop deposits that may impair organ functioning. The use and abuse of laxatives can cause serious bowel perforations requiring

surgical intervention.

Bone Problems

Anorexia can disrupt the regular bone growth of adolescents due to insufficient mineral availability resulting from a restricted diet. Boys and girls with anorexia are more likely to have growth deficiencies and are at heightened risk for severe bone disease as a result. Females, however, are especially susceptible to long-term bone problems. For example, peak bone mass is usually achieved prior to age 30. However, a young woman who develops anorexia as an adolescent may not reach peak bone mass, which places her at an increased risk for bone fractures and stunted growth. In addition, poor nutrition, low body weight, and decreased estrogen production resulting from malnourishment dramatically increase the likelihood of developing early osteoporosis in females. This higher risk is not just found in older women. Approximately half of young females with anorexia have osteoporosis, which can result in significant joint pain, tooth loss, bone fractures, and disability. In 2002, the International Journal of Eating Disorders reported that anorexia patients are twice as likely as those without anorexia to break a bone. This risk of bone fracture remains for 10 years after diagnosis.

It should also be noted that the results of recent research suggest that males with anorexia are likewise at increased risk for osteoporosis. Some of the potential consequences of osteoporosis and osteopenia are long lasting and may cause permanent skeletal damage. A bone density test can determine the extent of bone loss and can be used by physicians in determining if hormone replacement therapy, medication used for treating bone loss, or calcium supplementation may help restore bone density or prevent bone loss.

 Lanugo

Lanugo is a fine, downy white hair that may grow on the body as a result of malnutrition. Referred to as “peach-fuzz,” it is usually most noticeable on a patient’s face, neck, arms, and back. Lanugo growth is one of the ways in which the bodyattempts to adjust to the slowing down of the metabolism that occurs with prolonged fasting and weight loss. With any significant weight loss that reaches the point of semi-starvation, the body’s core temperature drops; patients in this state report feeling cold most of the time as a result. Lanugo is, in essence, a way that the body tries to keep itself warm. It is not, in itself, harmful, but signals that the body has reached dangerous levels of malnutrition. It does not grow in all cases of anorexia, but it can be frightening when it does occur. Lanugo can be reversible, and the key is to get one’s body back to a healthy state where it is nourished and well-fed.

Lynn shares:

During my years in anorexia, I can remember running a race on a hot day and toward the end of it, having the sensation of my whole body cramping up. It felt like I was in one of those slow motion dreams. I finished the race (even won it), but later felt all sorts of heart arrhythmias that were very frightening. Much later, when I finally saw a doctor, blood work results showed one of the lowest blood potassium levels ever seen in an ambulatory patient. You can look quite normal, even perform superbly well, yet be in a very dangerous state. I developed anorexia just before puberty. As a result I never started my periods until age 28. Throughout the eating disorder, powdered milk was a mainstay for me, and I was very active with weight bearing exercise. I theorized that this combination might save me from the predicted bone loss. Following recovery, and for the next two decades, I continued with everything possible to achieve and maintain good bone health-adequate calcium and associated vitamins and minerals, strength training, and weight bearing exercise. At age 50 I was still diagnosed with osteopenia of the spine.

Terms:

Anorexia - has the highest premature death rate of any mental illness.

Aggregate death rate - Sum or total death rate over time.

Electrolytes - Salts that are found in the body, the most common of which are sodium, potassium, and chloride. A healthy balance of electrolytes is needed to maintain normal body function.

Arrhythmia - An abnormal or irregular rhythm of the heart.

Gastroparesis - Nerve or muscle damage in the stomach that causes slow digestion and gastric emptying, vomiting, nausea, or bloating.

Peak bone mass - The stage of growth at which bones have reached maximum density and strength.

Osteoporosis - A condition characterized by a progressive decrease in body density. Osteoporosis produces dry, brittle bones that may easily crack or collapse. Approximately half of young females with anorexia have osteoporosis.

Osteopenia - A decrease in bone density that is less severe than in osteoporosis.

Bone density test - A test that measures the strength and density of bones; often used to determine the risk of developing osteoporosis. Also called bone mineral density (BMD) test.

Lanugo - A fine, downy white hair that may grow on the body as a result of malnutrition

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