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Cited by 467Eating Disorders and BehaviorsNutrition, Health and Food BehaviorChild Nutrition and Feeding Issues

Medical complications of anorexia nervosa and bulimia

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Westmoreland, Patricia, Krantz, Mori J., Mehler, Philip S.·2016·The American Journal of Medicine
DOI 10.1016/j.amjmed.2015.06.031
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Abstract

Anorexia nervosa and bulimia nervosa are serious psychiatric illnesses related to disordered eating and distorted body images. They both have significant medical complications associated with the weight loss and malnutrition of anorexia nervosa, as well as from the purging behaviors that characterize bulimia nervosa. No body system is spared from the adverse sequelae of these illnesses, especially as anorexia nervosa and bulimia nervosa become more severe and chronic. We review the medical complications that are associated with anorexia nervosa and bulimia nervosa, as well as the treatment for the complications. We also discuss the epidemiology and psychiatric comorbidities of these eating disorders.

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  • Unlike cancer or Alzheimer's disease, most medical complications associated with anorexia can be treated with adequate nutritional intake and weight restoration, even in severely emaciated patients.

    “Unlike cancer or Alzheimer’s disease, most medical complications associated with anorexia can be treated with adequate nutritional intake and weight restoration, even in severely emaciated patients (3, 146).”

    From Assisted death in eating disorders: a systematic review of cases and clinical rationales (2024) · cites this paper as [146]

    The Clinical Significance section says most complications are reversible with early effective treatment, and the Hematology section gives weight restoration as a treatment that resolves cytopenias. The paper does not establish that this holds for most complications even in severely emaciated patients, nor does it compare anorexia with cancer or Alzheimer’s disease. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • These impairments contribute to a vicious cycle where malnutrition exacerbates cognitive deficits that hinder effective treatment engagement and decision-making, resulting in a pattern of diminished capacity that fuels the disorder itself.

    “These impairments contribute to a vicious cycle where malnutrition exacerbates cognitive deficits that hinder effective treatment engagement and decision-making, resulting in a pattern of diminished capacity that fuels the disorder itself (146).”

    From Assisted death in eating disorders: a systematic review of cases and clinical rationales (2024) · cites this paper as [146]

    The Neurologic section says malnutrition in anorexia nervosa causes brain atrophy and that neurocognitive functioning may remain impaired. It does not link those impairments to treatment engagement, decision-making capacity, or a self-perpetuating cycle of illness. Page numbers are not available in our copy. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Most medical complications of anorexia nervosa are reversible with nutritional rehabilitation and expert care.

    “most medical complications are reversible with nutritional rehabilitation and expert care [9].”

    From Terminal anorexia nervosa is a dangerous term: it cannot, and should not, be defined (2022) · cites this paper as [9]

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Cites

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1 of the 121 references couldn’t be matched to a known paper.

Research works printed but not linked: 18

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  5. Rossiter EM, Agras WS, Telch CF, Schneider JA. Cluster B per- sonality disorder characteristics predict outcome in patients with bulimia nervosa. Int J Eat Disord. 1993;13:349-357.
  6. McKnight RF, Park RJ. Atypical antipsychotics and eating disorders: a review. Eur Eat Disord Rev. 2010;18:10-21.
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  9. Brown RF, Bartrop R, Beaumont P, Birmingham CL. Bacterial in- fections in anorexia nervosa: delayed recognition increases compli- cation. Int J Eat Disord. 2005;37:261-265.
  10. Kraeft JJ, Uppot RN, Heffess AM. Imaging findings in anorexia nervosa. AJR Am J Roentgenol. 2013;200:328-334.
  11. Vestergaard P, Emborg C, Stovving RK, Hagen C, Moseklide L, Brixen K. Fractures in patients with anorexia nervosa e a nationwide register study. Int J Eat Disord. 2002;32:301-308.
  12. Stokosh GR, Friedman AJ, Wu SC, Kamin M. Effects of oral con- traceptive on bone mineral density in adolescent females with anorexia nervosa. J Adolesc Health. 2006;39:819-827.
  13. Golden NH, Iglesias EA, Jacobson MS, et al. Alendronate for the treatment of osteopenia in anorexia nervosa. J Clin Endocrinol Metab. 2005;90:3179-3184.
  14. Devlin MJ, Walsh BT, Katz JL, et al. Hypothalamic-pituitary-gonadal function in anorexia nervosa. Psychiatry Res. 1989;28:11-16.
  15. Miller KK, Grinspoon S, Gleysteen S, et al. Preservation of neuro- endocrine control of reproductive function despite under nutrition. J Clin Endocrinol Metab. 2004;89:4434-4438.
  16. Utiger RD. Altero thyroid function in non-thyroidal illness and sur- gery. To treat or not to treat. N Engl J Med. 1995;333:1562-1567.
  17. Baechle C, Castillo K, Strasburger K. Is disordered eating behavior more prevalent in adolescents with type 1 diabetes then in their respective peers? Int J Eat Disord. 2014;47:342-352.
  18. Strumia R, ed. Eating Disorders and the Skin. New York: Springer Publishing Company; 2012.

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Authors
Westmoreland, P., Krantz, M. J., & Mehler, P. S.
Affiliations
Denver Health Medical Center (US)
Corresponding author
Mehler, Philip S.
ORCID
Venue
The American Journal of Medicine
Publisher
Elsevier BV
Published
2016-01
Volume
129
Issue
1
Pages
30-37
ISSN
0002-9343 (ISSN-L)
DOI
10.1016/j.amjmed.2015.06.031
OpenAlex
W808601510
Cited by
467
References
121
Citations by year
2026: 33 · 2025: 55 · 2024: 36 · 2023: 58 · 2022: 56 · 2021: 56 · 2020: 61 · 2019: 43 · 2018: 17 · 2017: 17 · 2016: 16 · 2013: 1
FWCI
2.39
Type
journal article
Language
en
Open access
Licence
Locations
  • The American Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
  • Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords
anorexia nervosa, bulimia nervosa, eating disorders, medical complications, malnutrition, weight loss, purging behavior, body image distortion, psychiatric comorbidity, complication treatment
MeSH terms
Anorexia Nervosa, Humans, Comorbidity, Bulimia Nervosa

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