Eating Disorders: The Medical Reality

I wrote this last year as part of one of my nursing courses. This particular piece does not address Binge Eating Disorder, though that can be just as deadly.


Eating Disorders: The Medical Reality

by Sarah Henderson


There are two main types of eating disorders that are generally diagnosed: anorexia nervosa and bulimia nervosa.


Anorexia nervosa is defined by the DSM-IV as:

Refusal to maintain body weight at or above a minimally normal weight for age and height (weight loss leading to maintenance of body weight less than 85% of that expected)

Intense fear of gaining weight or becoming fat, even though underweight.

Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body shape on self-evaluation, or denial of the seriousness of the current low body weight.

The absence of at least three consecutive menstrual cycles.


Bulimia Nervosa is defined as:

Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

1)Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.

2)A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).

Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, enemas, or other medications; fasting, or excessive exercise.

The binge eating and inappropriate compensatory behaviors occur, on average, at least twice a week for three months.

Self-evaluation is unduly influenced by body shape and weight.


Eating disorders have very little to do with weight or food. Variations for all who suffer can be anywhere from extremely underweight to extremely overweight to anywhere in between. The outward appearance of anyone with an eating disorder does NOT dictate the amount of physical danger they are in, nor does is determine the emotional conflict they feel inside. A person with an eating disorder may have only a few symptoms or may be on the verge of death. For the most part however, like many mental illnesses, you would not know they were suffering unless they admitted it to you.

Of all the known mental illnesses, eating disorders have the highest mortality rate; about 20%. Let’s take a look at the devastating effects that anorexia nervosa and bulimia nervosa can have on the body and it’s systems.


Some of the most common medical complications of anorexia and bulimia include: gastric ulcers, gastric esophageal reflux disease (GERD), irritable bowel syndrome, anemia, electrolyte imbalance, orthostatic hypotension, bradycardia (slow heart rate), arrythmia, heart muscle atrophy, poor circulation, hair loss, fine hair growth (lanugo), callused or bruised knuckles from the fingers being forced down the throat to induce vomiting, osteopenia, osteoporosis, severe erosion of tooth enamel, muscle weakness, ketoacidosis, amenorrhea, hormonal imbalances, syncope (fainting), glucose disturbances, gum disease, difficulty with concentration, irritability, anxiety, mania, depression, obsessive thinking, insomnia, and mood lability


Other possible complications include: rhabdomyolysis (muscle wasting), blindness (due to vitamin A deficiency), infertility, suicide attempts, high cholesterol, kidney infection, pancreatitis, brain atrophy, transient paralysis (due to potassium deficiency), low white blood cell count leading to impaired immune system, bone fractures, and gallbladder disease


The following complications are potentially (or always) fatal: gastric or esophageal rupture, severe rectal bleeding due to laxative abuse, heart attack, cardiac arrest, stroke, seizures, swelling of the brain due to electrolyte imbalance, aspiration pneumonia from inhaling vomit, liver failure, kidney failure, heart failure, multi-system organ failure, and suicide


If someone you know is exhibiting any symptoms of an eating disorder it is imperative that they receive help as soon as possible, for both their psychological and physical well-being. Otherwise, they could end up being just another statistic.


About writingforrecovery

Sarah is a writer and poet who speaks out about issues that make people uncomfortable. Sarah advocates for causes such a sexual assault, domestic violence, child abuse, and mental illness, and often speaks openly about her own experiences. She is determined to abolish the stigma associated with these issues and believes that it starts with people telling their stories, so she started a blog called Writing for Recovery where people can do just that. She is the author of three volumes of poetry and is currently at work on her fourth. She is convinced that there's a novel somewhere in her, and occasionally picks at the chapters so far. View all posts by writingforrecovery

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