National Eating Disorders Association

The health consequences of OSFED depend in part on which eating disordered behaviors are being used. Some of the medical consequences of OSFED may include:

  • Abnormally slow heart rate and low blood pressure, which mean that the heart muscle is changing. The risk for heart failure rises as the heart rate and blood pressure levels sink lower and lower.
  • Reduced resting metabolic rate, a result of the body’s attempts to conserve energy.
  • Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death. Electrolyte imbalance is caused by dehydration and loss of potassium, sodium and chloride from the body as a result of purging behaviors.
  • Potential for gastric rupture during periods of bingeing.
  • Inflammation and possible rupture of the esophagus from frequent vomiting.
  • Tooth decay and staining from stomach acids released during frequent vomiting.
  • Chronic irregular bowel movements and constipation as a result of laxative abuse.
  • Constipation.
  • Slowed digestion, which can lead to feeling full after very small amounts of food.
  • Muscle loss and weakness.
  • Severe dehydration, which can result in kidney failure.
  • Fainting, fatigue, and overall weakness.
  • Dry hair and skin; hair loss is common.
  • Growth of a downy layer of hair called lanugo all over the body, including the face, in an effort to keep the body warm.
  • High cholesterol levels (note: this is NOT an indication to restrict dietary fats, lipids, or cholesterol).
  • Peptic ulcers and pancreatitis.
  • Delayed stomach emptying.
  • Fainting, fatigue, and overall weakness.
  • Dry hair and skin; hair loss is common.
  • Severe dehydration, which can result in kidney failure.
  • Swollen parotid (salivary) glands in front of the ears and at the base of the jaw.
  • Frequent sore throats and hoarse voice.
  • Broken blood vessels within the eyes.
  • Seizures resulting from dehydration.
  • Muscle cramps.
  • Tingling in hands and feet.
  • Menstrual irregularities. Monthly periods while on oral contraceptives is not evidence of menstruation.
  • Liver enzyme elevations.
  • Reduced white blood cell counts, which can increase susceptibility to infection.
  • Anemia.
  • Sleep disturbances, including insomnia and increased fatigue.
  • Hypothermia (low body temperature).
  • Pressure sores, such as on the lower back from sitting in hard chairs.
  • Easy bruising.
  • Delayed wound healing.
  • Low levels of sex hormones (estrogen in women and testosterone in men).
  • Low bone density (osteoporosis and osteopenia), which significantly increases risk of bone fractures.

References:

Brown, CA and Mehler, PS. Medical complications of self-induced vomiting. Eating Disorders. 2013;21(4):287-94.

Brown, CA and Mehler, PS. Successful “Detoxing” From Commonly Utilized Modes of Purging in Bulimia Nervosa. Eating Disorders. 2012; 20(4): 312-20.

Mehler, PS and AE Anderson. Eating Disorders. Baltimore: Johns Hopkins UP, 2010. Print.

Mitchell, J. E., & Crow, S. (2006). Medical complications of anorexia nervosa and bulimia nervosa. Current Opinion in Psychiatry, 19(4), 438-443.