Eating disorders

Perhaps you know somebody with an eating disorder, or perhaps you suffer from one yourself. It’s not that rare and can be a way to cope with life. People with eating disorders try to control their weight by not eating (anorexia nervosa) or by eating too much (bulimia nervosa). If a person has anorexia nervosa, there is also a risk that their heart will be affected.

Severe anorexia can lead to heart failure. The margins are narrower for a person with a congenital heart defect who also suffers from anorexia.  Because of the variation in congenital heart defects, it is difficult to say exactly how someone with a congenital heart defect will fare if they develop anorexia, but such patients do have narrower margins and are more susceptible. Anorexia poses a greater threat to such teenagers and GUCHs (grown-ups with congenital heart defects) from a purely circulatory standpoint, and the narrower margin is more evident in such cases. 

Different types of disorders

Eating disorders are usually divided into three types, the first being anorexia nervosa, where one starves oneself, and the second being bulimia nervosa, where one binges and then tries to purge the food by, for instance, vomiting. Anorexia nervosa mainly affects teenage girls, while bulimia mainly affects women over the age of 20.  

The third group of disorders comprises those known as atypical disorders and includes orthorexia, a variant of anorexia nervosa. A person who suffers from orthorexia has a compulsive need to be healthy and have control over their body. Sports anorexia is another atypical disorder, in which athletes become visibly underweight in their efforts to achieve good results. Binge eating is yet another atypical disorder, and a variant of bulimia nervosa. People who suffer from this condition do not try to purge themselves of whatever they have eaten. Obesity is now often referred to as an atypical disorder as well, because of the element of binge eating intrinsic to obesity.

Anorexia nervosa

It is primarily anorexia nervosa that can lead to serious heart problems. Anorexia sufferers are usually women; only about 10% of those affected are men. The causes of anorexia vary and multiple factors are often involved. Dieting can serve as a trigger, and factors such as low self-esteem and thinking that life would be better if one were thin are sometimes involved. These notions may in turn derive from modern ideals of beauty. Anorexics strive for control over their bodies, and dislike for their own bodies is not unusual.

What happens in the body?

When a person's normal bodily functions are no longer being maintained and the body begins to starve, that person has anorexia nervosa. One indication is when menstruation ceases because the body has stopped producing oestrogen. Weighing 85% of one's expected weight is a common way of defining a state of starvation (taking into account height, age and gender). Measuring the BMI (Body Mass Index) is another approach. A normal BMI is between 20-25, while an anorexic will have a BMI of less than 18.

The heart

Prolonged starvation deprives the heart of the nutrition it needs to pump blood, making it slower and less efficient. The heart is under severe strain, and the pulse rate and blood pressure fall. Anorexia can lead to heart failure, arrhythmias or heart attack in severe cases. These conditions may result in sudden cardiac death

Food gives us energy

Food gives us energy to keep our bodies going and provides the nutrients that our organs require. The body has a special signalling system that tells us when we need new food, i.e. when we are hungry. This is how we regulate our body weight. This signalling system is disabled by self-starvation. Digestion decreases, and the pulse rate and blood pressure decline. Kidney function may be impaired and loss of oestrogen production not only puts an end to menstruation, but also increases the risk of osteoporosis. Teenagers and GUCHs have far less fat deposits and energy stores, and may thus be more susceptible, and more likely to find themselves in the situation of having extremely low fat deposits and energy stores. The bulimic's combination of self-starvation with binge eating also alters the way the body uses energy.

Restoring the body

Most of the physical problems will vanish once self-starvation ends. When anorexia patients are admitted for care, they are given energy drinks several times a day. These drinks give the heart the energy to start working better again, and the heart often recovers even before the patients begin to gain weight.  If the anorexia is severe one should be careful when one starts to give nutrition. Too much nutrition too fast could put a lot of strain to the heart because it takes time for it to adjust.  It is certainly possible to regain one's health after having an eating disorder, but it may take time. Because of the psychological components, eating disorders are also treated through therapy. The more compulsive the eating disorder, the longer it will usually take to regain one's health. Recidivism is also common during the recovery process. 


Clinton, David and Norring, Claes (ed.), Ätstörningar- Bakgrund och aktuella behandlingar [Eating disorders – Background and current treatments], Natur och Kultur 2002 The Knowledge Centre for Eating Disorders, Karolinska Institutet accessed on: 27/05/2009

Child and youth psychiatry in Stockholm (BUP) accessed on: 26/05/2009  UMO Your new paediatric clinic, Sjukvårdsrådgivningen, accessed on:  25/05/2009

Psychiatry Skåne, s accessed on visited 1 1/05/June 2009

Dellborg Mikael, GUCH Professor, Östra sjukhuset Gothenburg, interviewed  01/06/2009

Author(s): Ulrika Hallin
Reviewed by: Ulf Wallin
Last updated: 2009-08-26

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Comments on this article

02.12.2011 | Ramona Schorcht, Deutschland
Ich habe gerade euren Artikel über Esstörungen gelessen, habe selber welche bei einem BMI über 40 bin ich auch ziemlich übergewichtigt, dazu kommt das ich einen angeborenen schweren Herzfehler habe (TOF) und angeblich noch Zuckerkrank bin, wobei die einen sagen es wäre Zucker die anderen sagen es wäre keiner da müßte das mit den werten anders Reagieren, ja und Heißhunger Atagen kenne ich auch. Inzwischen versuche ich sie so in den griff zu bekommen, das ich versuche mehr zu trinken und wenn ich Hunger bekommen sollte einen
Salat zu essen, hinzu kommt dann wirklich solche Gedanken wie, Mensch früher haste doch auch mehr gegessen. Ich vergesse eben auch oft das mann etwas Älter geworden ist.