Eating Disorders: Anorexia and Bulimia
DescriptionAn in-depth report on the treatment and prevention of eating disorders.
Alternative NamesAnorexia; Bulimia
Complications of Bulimia
Most studies report that patients with bulimia that is not accompanied by severe weight loss have a much better outlook than patients with anorexia. Some studies have suggested that between 60% and 80% of bulimic patients are in remission within three months of treatment. However, relapse is common and over half of women with bulimia continue to battle disordered eating habits for years. In one study, bulimia itself persisted in 10% to 25% of patients after treatment.
Direct Adverse Effects of Bulimic Behavior on the Body
The following are medical problems directly associated with bulimic behavior, including self-induced vomiting and laxative abuse:
Long-Term Health Problems
Studies have been mixed on the long-term health consequences for bulimic people who maintain normal weight and who do not go on to become anorexic. Some report no major problems. A 2002 study, however, reported that eating disorders during adolescence put these young people at risk for a variety of psychologic and medical problems later on, even in those without severe eating disorders. Health problems included circulatory disorders (such as high blood pressure), neurologic symptoms (such as seizures), chronic fatigue, headache, frequent flus and colds, and insomnia, regardless of weight loss. Even worse, only 22% of the subjects had received any psychiatric treatment. The study did not break down specific eating disorders, but related the health problems with specific behaviors. Furthermore, another 2002 study reported that bulimic patients were at higher risk for bone fractures. (The risk was lower than with anorexia and, unlike in anorexia, it returned to normal within a year of diagnosis and treatment.)
In all cases, patients who have both bulimia and anorexia are in greatest danger of health risks.
Long-Term Psychiatric Problems
In the 2002 study mentioned above, eating disorders, even with normal weight, were associated with a higher risk for anxiety and depressive disorders and with suicide attempts.
Effect on Pregnancy
Most pregnant women with a history of eating disorders have healthy pregnancies, although they face higher risks for a number of complications, including cesarean sections, postpartum depression, miscarriages, and complicated deliveries. Their babies may also have a higher risk for low birth weight, prematurity, and malformation. A 2004 study of women who had been previously hospitalized for eating disorders found that their risk of pre-term delivery was increased by 70-80%, and their chance of having a low-birth-weight infant doubled.
A number of self-destructive behaviors occur with bulimia:
Abuse of Over-the-Counter Medications
Women with bulimia frequently abuse over-the-counter medications, such as laxatives, appetite suppressants, diuretics, and drugs that induce vomiting (e.g., ipecac). None of these drugs is without risk. For example, ipecac poisonings have been reported, and some people become dependent on laxatives for normal bowel functioning. Diet pills, even herbal and over-the-counter medications, can be hazardous, particularly if they are abused.