A sampling of consequences of prolonged restricting (dieting/starving), purging (vomiting,using laxatives and/or diuretics), and/or excessive/compensatory exercising

Neurological and Cardiovascular Problems

• Irregular heartbeats, lowered heart rate and blood pressure (can result in dizziness)
• Altered brain function and size
• Convulsions
• Death due to heart failure

Digestive Problems

• Loss of enamel and dentin on teeth (not moderated by brushing), leading to tooth and gum decay
• Inflammation of throat or esophagus or tears in esophagus
• Gastrointestinal distress (may prevent proper absorption of nutrients)
• Dependence on laxatives (impaired intestinal motility)
• Increased incidence of bowel tumors
• Bowel problems (constipation, abdominal pain, bloating)
• Kidney damage or failure (can result in death)s

Skin and Skeletal Condition

• Permanent scars on knuckles of hand used to induce vomiting
• Dry mouth, coated tongue, cracked lips; dry skin
• Edema (water retention)
• Reduced body temperature and intolerance to cold temperatures; growth of lanugo (downy hair)
• Thinning of scalp hair
• Osteoporosis
• Muscle spasms and weakness

 Reproductive Problems

• Irregular menstruation/amenorrhea (loss of menstrual cycle)
• Decreased sex drive

• Preoccupation with thoughts about food and eating, but difficulty judging hunger/satiety
• Impaired concentration and memory
• Depression, apathy, suicidal feelings/attempts
• Loss of interest in and motivation to engage in activities previously enjoyed
• Irritability, anxiety, moodiness
• Sleep disturbance
• Withdrawal in social relationships; secretiveness; the eating disorder becomes "best friend" and
• primary emotional coping mechanism
• Increasingly distorted view of self (including body image, skills and abilities, worth)
• Co-morbidity: Nearly 50% of individuals with eating disorders also suffer from depression,anxiety disorders, post-traumatic stress disorder, obsessive-compulsive disorder, or substance abuse. (These may be predisposing factors or consequences of eating disorders.)

• Improved capacity for athletic performance initially, followed by weakness, fatigue, injury, or illness which impairs athletic performance
• Restrictive eating in combination with excessive exercise leading to intense strain on heart
• Inability to achieve weight-loss goals (regardless of exercise) due to slowing of metabolic rate from excessive dieting
• Extreme sensitivity to any judgment about body image or weight; may use external references to weight or body image as justification for intensively restrictive eating behavior

• Absence from class (due to fear of attracting attention and possible judgment from others,
• physical fatigue or weakness, fainting/blackouts during class, or involvement in
• eating/purging/exercising rituals and behaviors)
• Difficulty concentrating; impaired memory; decreased examination performance
• Avoidance of others, impaired help-seeking behavior (e.g., from advisors, instructors, tutors) and
• teamwork (e.g., group class projects)

• Electrolyte disturbances
• Loss of protein and fat required for nutrient absorption, energy, and warmth
• Loss of other essential nutrients, including calcium, potassium, sodium
• Dehydration followed by rebound fluid retention (and swelling/bloating)
• Slowing of metabolic rate; weight gain or stabilization despite increased dieting or purging

Prepared by the Eating Disorders and Body Image Concerns Task Force, George Mason University, May 2000