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The Eating Disorders Programme from​ the Department of Psychiatry at Singapore General Hospital​ (SGH), a member of the ​SingHealth​​ group, shares the complications that arise from eating disorders if left untreated.

Having an eating disorder can affect all aspects of an individual's life

1. Medical risks of eating disorders

If not stopped, eating disorders can lead to irre​versible physical damage and even death. They can affect every cell, tissue and organ in the body.

The following is a partial list of the medical dangers associated with anorexia nervosa, bulimia and binge eating disorders:

  1. Irregular heartbeat, cardiac arrest, death
  2. Kidney damage, renal failure
  3. Liver damage
  4. Loss of muscle mass. Stick-thin arms and legs
  5. Permanent loss of bone mass. Fractures and lifelong problems caused by fragile bones and joints. Osteopenia, osteoporosis, and dowager’s hump.
  6. Destruction of teeth, rupture of esophagus, damage to the lining of the stomach, gastritis, gastric distress including bloat and distension.
  7. Disruption of menstrual cycle, infertility
  8. Delayed growth and permanently stunted growth due to under-nutrition. Even after recovery and weight restoration, the person may not catch up to expected normal height.
  9. Weakened immune system
  10. Icy hands and feet
  11. Swollen glands in the neck, stones in salivary duct, “chipmunk cheeks”
  12. Excess hair on face, arms and body (body’s attempt to be warm)
  13. Dry, blotchy skin that has an unhealthy gray or yellow cast
  14. Anaemia, malnutrition. Disruption of body’s fluid/mineral balance (electrolyte imbalance and loss of potassium can be fatal)
  15. Fainting spells, seizures, sleep disruption, bad dreams, mental fuzziness
  16. Low blood sugar (hypoglycemia) including shakiness, anxiety, restlessness and a pervasive itchy sensation all over the body
  17. Anal and bladder incontinence, urinary tract infections, vaginal prolapse and other problems related to weak and damaged pelvic floor muscles. Some problems may be related to chronic constipation, which is commonly found in people with anorexia nervosa. Structural damage and atrophy of pelvic floor muscles can be caused by low estrogen levels, excessive exercise and inadequate nutrition. Surgery may be necessary to repair the damage
  18. Because of changes in the brain associated with under-nourishment, binge eating and purging, the person does not and perhaps cannot weigh priorities, make judgments and make choices that are logical and rational for normal people

2. Psychological effects

As painful as the medical consequences of an eating disorder are, the psychological agony can feel worse. It is a sad irony that the person who develops an eating disorder often begins with a diet believing that weight loss will lead to improved self-esteem, self-confidence and happiness. The cruel reality is that persistent undereating, binge eating and purging have the opposite effect. Eating disordered individuals typically struggle with one or more of the following complications:

  1. Feel out-of-control and helpless to do anything about problems
  2. Anxiety, self-doubt
  3. Guilt and shame, feelings of failure
  4. Hypervigilance. Thinks other people are watching and waiting to confront or interfere
  5. Fear of discovery
  6. Obsessive thoughts and preoccupations
  7. Compulsive behaviors. Rituals dictate most activities
  8. Feelings of alienation and loneliness. “I don’t fit in anywhere.”

3. Social impact of having an eating disorder

Eating disorders bring pain and suffering not only to the people who have them but also their families, friends and romantic partners. Co-workers and even casual acquaintances can be affected too. These problems include:

  1. Disruption of family. Blame, fights over food, weight, treatment etc.
  2. Family members struggle with guilt, worry, anxiety, and frustration. Nothing they do seems to make things better.
  3. Friendships and romantic relationship are damaged or destroyed. Person with the eating disorder is or becomes emotionally cool and withdrawn, irritable, minimally or not at all interested in sex, secretive and controlling - often in a passive/aggressive manner.
  4. If the person is a student or athlete, the teachers, coaches and trainers may experience the same worry and frustration that plague the family members.

For more information and tips, download a FREE copy of the "Treating Eating Disorders: The SGH Experience" booklet.

Information modified from Anorexia Nervosa and Related Eating Disorder, Inc​. (ANRED)

See page 1 for the three types of eating disorders.

See page 2 for common causes of eating disorders.

See the next page for treatments for eating orders and coping tips.

​Ref: U11

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