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What Does Anorexia Do to the Body?
Written by Alicia Stevens, MD | Analysis by Karla Robinson, MD
Published on July 18, 2022
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Key takeaways:
Anorexia is a mental health condition in which someone has fears about weight gain or body shape. It can involve a severely restricted diet or medications to purge calories.
Anorexia affects every body system due to severe weight loss or nutritional deficiencies. Some of these effects can be fatal.
Treatment for anorexia can take place in a residential program or through a program that includes a hospital stay. The most successful treatments include nutritional counseling and therapy.
Romualdo Crissi/iStock via Getty Images
Eating disorders are a global issue, affecting about 9% of people worldwide. But this may be an underestimate of how widespread these mental health conditions are. That’s because these disorders can go many years before diagnosis.
Anorexia is a type of eating disorder in which someone has an intense fear of weight gain. As a result, they may do certain activities to avoid gaining weight, even when underweight. This is because the person may have an altered view of their body size and shape.
Excessive dieting, fasting, exercise, and significant weight loss are common. Sometimes there may be binging and purging behaviors, such as vomiting and overuse of laxatives, diuretics, or enemas. Over time, anorexia can have significant effects on the body. In severe cases, it can even be life-threatening.
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What causes anorexia?
Experts don’t know the exact cause of anorexia. Research shows that anorexia may be linked to many factors. These factors are:
Genetic: Those with a sibling or parent with anorexia are more likely to develop it.
Social: Cultures and settings that have a preference for low body weight can influence unhealthy eating patterns.
Physical: Altered brain signals can affect how the brain processes hunger, mood, and the behavioral response to food.
Psychological: Mental health conditions, like depression and anxiety, are linked to anorexia.
What are the symptoms of anorexia?
The main feature of anorexia is an intense fear of weight gain, but it may not look the same in everyone. The restrictive efforts among people with anorexia may show up in various ways.
Some common behaviors can include:
Persistent pursuit of thinness
Intense preoccupation with food that might include collecting recipes or hoarding food
Fear of certain foods or having a list of restricted foods
Overestimating the number of calories consumed
Overuse of condiments or artificially sweetened products
Obsessions with where and from whom to purchase food
Cutting food into small pieces or refusing to mix different types of food on the plate
Compulsions related to exercise, such as walking or running a set distance each day
Concerns about eating in public
Social withdrawal
Restlessness or hyperactivity
Feelings of being inadequate or a need for perfectionism
Need to control one’s environment
Inflexibility with changes to schedules or meeting places
Binging or purging (like vomiting or using laxatives after a big meal)
What are the common complications of anorexia?
The reduced food intake with anorexia can affect every area of the body. The complications are typically due to significant weight loss and nutritional deficiencies. The risk of more severe complications increases the longer you have anorexia. Proper nutrition and weight gain can reverse many (not all) complications.
Here are the top 10 ways that anorexia can affect the body:
1. Gastrointestinal effects
Digestive issues are common if you have anorexia. That's in part because the gastrointestinal (GI) system is lined with muscles. If you restrict your food intake, you can lose the ability to use these muscles effectively. This can cause trouble swallowing, constipation, and gastroparesis (delayed emptying of the stomach).
You may also begin to lose the ability to absorb nutrition properly. This can also lead to extreme electrolyte and fluid abnormalities. In severe cases, this can be life-threatening and cause refeeding syndrome at the start of treatment. This happens from the sudden shifts in fluids and electrolytes after restarting nutrition. If you’re below 70% of your ideal body weight or have had rapid weight loss, you may have a higher risk of refeeding syndrome.
Other GI complications from fluid and electrolyte shifts can include:
Diarrhea
Abnormal liver function tests
Small bowel obstruction (superior mesenteric artery syndrome)
2. Muscle and skeletal effects
The nutritional deficiencies from anorexia can cause muscle wasting. When starved, the body will also break down muscle as a source of energy. This can cause your muscles to become weak and fatigued, leading to low muscle tone. Loss of electrolytes and poor nutrition can also cause muscle pain and spasms.
About 90% of people with anorexia have bone loss complications. This is in part because your body needs calcium to function properly. Without an adequate diet, your body breaks down your bones to get the calcium it needs. This results in bone loss and can lead to osteoporosis, even as a young adult. These weakened bones can put you at an increased risk of serious fractures. These effects are often irreversible, even after treatment.
3. Heart effects
Anorexia also affects your heart muscle and can weaken it. This can affect the rhythm of your heart and how well it functions. A lack of proper nutrition can lead to low blood pressure and heart failure. Other heart complications can include:
Abnormal rhythm
Mitral valve prolapse
Bradycardia (slow heart rate)
Edema (swelling)
Pericardial effusions (fluid around the heart)
Myocardial atrophy (loss of heart muscle mass)
Sudden death
4. Lung effects
There are several ways that anorexia can affect your respiratory system. The extreme nutritional deficit can weaken your breathing muscles. Over time this can lead to respiratory failure. You may also be more likely to aspirate due to swallowing and digestive issues. This can cause serious respiratory infections like pneumonia.
Other pulmonary complications related to malnutrition can include:
Spontaneous pneumothorax (air leaks from the lungs into the chest)
Bronchiectasis (excess mucus in inflamed airways)
Emphysema-like lung changes
5. Kidney effects
The kidneys are important for proper electrolyte and fluid balance in the body. The restrictive diet in anorexia can cause the kidneys to stop functioning properly. This can lead to many complications, including:
Acute kidney injury (short-term kidney injury that can be reversible)
Chronic kidney disease (long-term kidney damage)
Hypokalemia (low potassium)
Hyponatremia (low sodium)
6. Hormonal effects
Nutrition can have a big impact on how your body produces and regulates hormones. A common example is a change in someone’s menstrual cycle. More than 2 out of 3 of people with anorexia have amenorrhea (no monthly period). This can lead to infertility and further issues of bone loss.
Other hormonal complications can include:
Inability to regulate body temperature
Hypoglycemia (low blood sugar)
Abnormal thyroid function levels
Miscarriage
Low testosterone levels
Low libido
Premature birth
Low birth weight baby
7. Neurological effects
One of the most severe complications affecting the brain is Wernicke’s encephalopathy. This happens because of a vitamin B1 deficiency. It can cause walking difficulties, severe amnesia, visual disturbances, and confusion. This condition is a medical emergency and requires treatment right away to avoid permanent damage.
Anorexia can cause other neurological complications, including:
Loss of brain volume
Altered taste
Seizures
Tremors
8. Ophthalmologic effects
Nutritional deficiencies can result in thinning of the back of the eye. This can lead to severe visual changes. Sometimes the vision problems are reversible, but they can be permanent.
Other effects on the eyes may include:
Permanent vision loss
Retinal changes
Inability to close eyelids completely
9. Dermatologic effects
Anorexia can cause severe dehydration. This can impair your body’s ability to naturally moisturize the skin. This can lead to dry, scaly skin. The dry skin can be so severe that it causes cracking and bleeding.
Anorexia can affect the skin in other ways, including:
Acne
Ulcers on skin overlying bones (due to loss of overlying fat)
Bluish discoloration to the fingertips and toes
Bruising
Poor wound healing
Fine hair growth on the face and back
10. Hematologic effects
Poor nutrition can lead to decreased iron intake. This can cause iron-deficiency anemia. Ongoing nutritional deficiencies can lead to changes in bone marrow. The result is a decreased production of white blood cells and platelets.
Neutropenia, or a low white blood cell count, can lead to an increased risk of infections. A low platelet count (thrombocytopenia) can cause easy bruising and bleeding.
Why is anorexia so dangerous?
Anorexia carries the highest death rate of any mental health disorder. That’s in part because of the effects of the severe nutritional deficiencies. The exact cause of death in anorexia is often poorly understood. Possible leading causes of death include:
Sudden death
Suicide
Electrolyte disturbances
Hypoglycemia
Dehydration
Refeeding syndrome
How do you treat anorexia?
Some people can get help managing anorexia in the outpatient setting. This may involve a daily hospital stay with several hours of outpatient care each week. Care can also take place in a specialized residential treatment facility for eating disorders.
Antidepressants may be helpful in the short term, but they shouldn’t be used alone. Studies have not shown that they consistently prevent relapse long term. Your provider may consider using medication along with intense counseling and dietary management.
Treatment involves slowly introducing food to reduce the risk of refeeding syndrome. It also focuses on addressing any electrolyte disturbances. Your treatment plan is unique to your nutrition needs. It also depends on how severe your symptoms are.
Severe cases require hospitalization. If you need hospital treatment, you may have the following symptoms:
Weight less than 70% of your ideal body weight
Heart complications
Poor response to outpatient management
Refeeding syndrome
Complications from malnutrition
Severe dehydration
Anorexia treatment often needs input from many medical specialties. This is due to its effects on various parts of the body. The best long-term results occur when nutritional counseling and therapy are used together.
The bottom line
Anorexia is a serious eating disorder that affects every system in the body. The good news is that most symptoms improve once you resume proper nutrition. Treatment for anorexia can take place in a variety of settings, depending on the severity of the condition. The most successful treatment includes a combination of nutritional counseling and therapy. If you have concerns about your weight or body size, talk with your healthcare provider for guidance.