Symptoms and Complications of Anorexia and Bulimia

THIS IS NOT A COMPLETE LIST!!! The symptoms/complications are in alphabetical order with both phyisical and behavioral symptoms mixed.

Symptoms and complications listed are for anorexia, bulimia, and EDNOS. Not listed are: binge eating disorder, anorexia athletica, over-exercise, night eating, overeating, orthorexia. I will get more information on those and add them later. For now there are just three types listed. Symptoms and complications specific to bulimia will have this symbol ♦ in front of it Symptoms and complications specific to anorexia will have this symbol ♣ in front of it. Though a symptom may be specified to one eating disorder or the other, it can still exist in someone without that specific disorder.

• Abnormal blood counts
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• Abnormal eating rituals (cuts food up small, moves food on plate but doesn't eat it)
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• Absence of menstruation or becoming shorter and lighter
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• ♦Acid reflux or ulcers
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• ♦Alternating between overeating and fasting
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• Anemias----{ a condition in which the blood is deficient in red blood cells, in hemoglobin, or in total volume}
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• Angry when confronted about food or weight
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• Anxiety when eating in front of other people
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• Avoidance of social situations where food may be present
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• Avoids or skips meals regularly
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• Bathroom visits after meals
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• Becoming withdrawn
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• Believing too fat even when thin
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• ♦ Binge eating
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• Bloating
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• Blood flow is reduced.
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• Bluish discoloration of the fingers
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• Bone loss
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• ♣Breast atrophy--------{a wasting away of an organ or part, or a failure to grow to normal size as the result of disease, faulty nutrition, etc. any degeneration or diminution, esp through lack of use}
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• Brittle nails
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• ♦Broken blood vessels in the eyes
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• Cardiac arrest and death
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• Chest pain
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• ♦ Chronic sore throat, hoarseness
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• ♣ Cold hands and feet
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• Complaining of being "too fat", even when thin
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• Compulsive exercising
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• Concern about being overweight
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• Constipation
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• Controlling behavior
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• ♣Cooks for others but does not eat herself
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• ♦Decayed teeth 
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• Decreased metabolic rate
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• Dehydration
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• Denial of hunger
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• ♣Denial of low body weight
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• Denial that they are ill
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• Depression
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• Desire to lose weight
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• Difficulty concentrating
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• Distortion of body image
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• ♦Diuretic use (increases amount of urination)
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• Dizziness
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• Dry skin
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• ♦Eating until they become sick
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• Edema (water retention)
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• ♣Electrolyte imbalances
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• Emaciation
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• ♦Esophagus inflammation - from purging or vomiting
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• Exercise more than 1 hour a day 3 to 4 days a week to control weight
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• Excessive thirst
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• Excessive preoccupation with food
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• Excessive urination
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• ♣Excessive weight loss
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• Excuses for not eating meals (ie. ate earlier, not feeling well)
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• Exhibits an obvious reduction in eating
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• Exhibits fear or anxiety before eating, and guilt after eating.
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• ♣Fainting
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• Fatigue
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• Fear of gaining weight
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• ♦Fear that once they start eating they won't be able to stop
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• Feeling out of control
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• Feeling that happiness is undeserved
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• Frequently looking in the mirror
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• ♣Find it difficult to consume a full normal portion of food (if it is due to fear of consuming it then it is behavioral however sometimes, especially in anorexia, the body gets used to eating small portions and can not take in a normal amount of food making it physical)
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• Guilt or shame about eating
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• ♦Going to the kitchen after everyone else has gone to bed. Going out alone on unexpected food runs. Wanting to eat in privacy.
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• Hair that thins, breaks or falls out
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• ♦Hand injuries from inducing vomiting 
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• Headaches
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• heart muscles starve, losing size.
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• Heart palpitations
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• ♦hides food
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• Hollow-looking eyes 
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• Hyperactivity
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• Ignoring feelings of hunger
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• Inability to remember things
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• ♦Inability to stop eating. Eating until the point of physical discomfort and pain.
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• Inability to tell whether or not they are full or hungry. The body's natural mechanisms for indicating hunger or satiety are disturbed.
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• ♣individual ribs and hip bones visible
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• Inflicting self-harm
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• Insecurities about capabilities regardless of actual performance
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• Insomnia
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• ♣Intentional starvation
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• Intense body dissatisfaction
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• Interpersonal conflicts
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• ♣Intolerance of cold
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• Irregular heart rhythms
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• Irritability
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• Infertility
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• Kidney and liver damage
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• Labeling food as either 'good' or 'bad' with generally an increased urge to binge on 'bad' foods.
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• Lack of energy
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• Lack of sexual interest
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• Light-headedness
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• Loss of body fat
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• Low blood pressure
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• ♣Low body temperature
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• ♣Low body weight.
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• Low potassium (most common cause of nocturnal cardiac arrest)
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• Low self-esteem
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• Low thyroid function
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• Malnutrition
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• Mood swing
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• ♣Muscle atrophy (wasting away of muscle mainly due to lack of use and/or lack of nutrition)
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• No known physical illness that would explain weight loss
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• Not feeling pain as you normally would.
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• Need for approval
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• Not wanting or refusing to eat in public
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• Noticeable discomfort around food
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• Obsession with weight
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• Obsessive-compulsive behavior
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• Obsessiveness about calorie intake
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• Osteoporosis
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• Pale complexion (almost a pasty look)
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• Perfectionist attitude
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• Playing with food
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• Preoccupation with tidiness
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• Preoccupation with food and calorie intake
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• Problems getting along with family members/long-time friends
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• Purplish skin color on the arms and legs from poor blood circulation.
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• ♦Puffy “chipmunk” cheeks
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• Refusing to eat
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• ♦Regular episodes of out-of-control binge eating
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• Repeatedly checking weight
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• ♦Repeatedly eating large amounts of food in a short period of time 
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• Resistance to treatment
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• Restricting food choices to only diet foods
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• Rigid eating schedule 
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• ♦Ruptured stomach or esophagus
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• Secretive about eating patterns
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• Self-worth is determined by food intake
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• Self-worth determined by weight
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• Severe self-criticism
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• Shortness of breath
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• Skin problems
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• Slow emptying of the stomach.
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• Slow heartbeat (fewer than 60 beats a minute).
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• ♣Soft, downy hair covering the body
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• Stomach pains
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• suicidal tendencies
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• Swelling of arms or legs
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• Swollen joints
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• Tiredness 
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• Thin appearance
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• Throws out food to avoid eating it
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• Under-eating 
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• Vulnerable to infections
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• Weakness
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• Wearing baggy clothes to hide weight loss
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• Wearing layered clothing - used to hide weight loss
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• Weighing foods
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• Withdrawal from friends, family and social situations
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• Won't eat in front of others
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• Yellow-orange skin, especially on the palms of the hands.

Diet Pills

Diet Pills

These range from common over the counter appetite suppressants such as phenylpropanolamine, caffeine pills and ephedrine hydrochloride (ephedrine is not an appetite suppressant, though often misused as one - commonly referred to as "white crosses" or "mini thins") to prescription medications like Redux and Phen/Fen. There are a wide variety of diet pills on the market that are available, many of them have addictive qualities, and some even contain small amounts of laxative.
Diet pills, both over-the-counter and prescription, (as recommended, continuously, or in excess) can cause the following: nervousness, restlessness, insomnia, high blood pressure, fatigue and hyperactivity, heart arrhythmias and palpitations, congestive heart failure or heart attack, stroke, headaches, dry mouth, vomitting and diarrhea or constipation, intestinal disturbances, tightness in chest, tingling in extremities, excessive persperation, dizziness, disruption in mentrual cycle, change in sex drive, hair loss, blurred vision, fever and urinary tract problems. Overdoses can cause tremors, confusion, hallucinations, shallow breathing, renal failure, heart attack and convulsions.
Prescription diet pills like the new and popular Phen/Fen (phentermine/fenfluramine) should never be taken without the written prescription of a doctor. There is an ongoing debate about their effectiveness, and all the health risks and benefits should be weighed. It should only be used in cases of extreme obesity. In addition to the health risks above, taking Phen/Fen increases your chances of Primary Pulmonary Hypertension, which is a disease that attacks the lungs, has a poor prognosis, and is fatal. Please Read the special announcement on the dangers of Phen/Fen and its link to valvular heart disease!
Caffeine pills and/or Ephedrine Hydrochloride should never be taken for weight control, and should not be taken continuously. Ephedrine is a medication used occassionally to treat asthma, but more commonly allergies and hayfever - it is a bronchial dialator. Both can cause all the side effects as diet pills, with an increased risk of addiction (both physical and psychological), headaches, high blood pressure and heart palpitations and arrhythmias, including heart attack. Ephedrine use can contribute to psychosis, anxiety and depression




Article from something-fishy.org

Laxitives and Ipecac Syrup

Laxatives
Pills or liquid, herbal or otherwise, laxative abuse is a common form of "weight control" in people suffering with Eating Disorders. The use of laxatives as a way to lose or control weight is not only dangerous, but irrational. The actual purpose of taking a laxative is to stimulate the large bowel to empty, which occurs only after the food and it's calories for energy have been absorbed through the small intestines. Essentially, a person taking laxatives to control weight is only going to cause their body to lose fluid, which can potentionally be followed by periods of water retention and an appearance of bloating (causing the sufferer to want to lose more weight and ingest more laxatives). The reason people suffering from eating disorders seem to lose weight while taking laxatives is because in most cases they are increasingly watching calorie intake and restricting food consumption, inducing vomiting, and/or compulsively exercising.
Continued laxative use can cause bloating, cramping, dehydration, electrolyte disturbances and imbalances, cardiac arrhythmias, irregular heart beat and heart attack, renal problems, and death.
Phenolphthalein, a popular ingredient previously found in many brands of laxatives has now been recalled by the FDA (Food and Drug Administration, United States) due to studies indicating that it has been linked to cancer.
Withdrawal symptoms can be expected in stopping the use of laxatives after a continued period of using them as a "weight loss" method. These include, abdominal cramping, mild to severe constipation, bloating, mood swings and general feelings of fatigue and "feeling sick." In less severe cases the symptoms will usually subside in about 2 weeks, but in cases where a person have ingested handfuls or more laxatives on a regular basis, it may take longer and require medical assistance.

Diuretics
Sufferers of Eating Disorders sometimes use diuretics as a way to attempt controlling their weight. Again, this is dangerous and irrational. Diuretics work on reducing water retention, and only decrease the amount of water in the body... this can cause dehydration and electrolyte imbalances and specifically potassium deficiencies that can result in hospitalization. Continued use can lead to long and short-term fluid retention even when the diuretics are discontinued.

Ipecac Syrup
The use of Ipecac Syrup can cause instant death! Using Syrup of Ipecac for anything other than its purpose (to induce vomitting in cases of accidental poisoning, or drug overdose) causes systemic toxicity which can cause weakness, tenderness and stiffness of muscles, cardiac disease and heart failure, coma, seizures, shock, increase in blood pressure, with possible hemorrhage, dehydration, aspiration pneumonia and death.
This cumulative effect (taking it more than once, for reasons other than its indications) can increase the possibility of serious adverse effects, and if ipecac fails to produce vomitting, patients should go to the hospital IMMEDIATELY.






Articles from something-fishy.org

Physical Dangers of Eating Disorders

Malnutrition - caused by undereating or overeating. It means your body is not getting enough of the appropriate vitamins for your body to work correctly. Blindness, heart attacks, and death can result from malnutrition.


Dehydration - Caused by lack of fluids, use of laxitives, vomiting, and restricting carbs and fat. Dehydration can be identified by symptoms such as dizziness, dark urine, lightheadness, dry sticky mouth, headaches, constipation, confusion, and syncope (fainting). It can cause the heart and kidneys to fail, seizures, and brain damage. Dehydration left untreated can be FATAL 


Electrolyte Imbalances - electrolyte are essential to the production of the body's "natural electricity" that ensures healthy teeth, joints and bones, nerve and muscle impulses, kidneys and heart, blood sugar levels and the delivery of oxygen to the cells.


Hyponatremia (related to "water-loading") - as stated above, electrolytes are essential to proper body functioning. Drinking too much water (more than eight, eight-ounce glasses in less than twelve hours), can cause Hyponatremia (not enough sodium in the blood), especially in someone already malnourished or dehydrated. Hyponatremia can cause fluid in the lungs, the brain to swell, nausea, vomiting, confusion and even death. YES, DRINKING TOO MUCH WATER CAN KILL YOU!!


Heart Attacks- Signs you're having a heart attack

• uncomfortable pressure, fullness, squeezing or pain in the center of the chest lasting more than a few minutes.
• Pain spreading to the shoulders, neck or arms.
• Chest discomfort with lightheadedness, fainting, sweating, nausea or shortness of breath.
• Atypical chest pain, stomach or abdominal pain.
• Nausea or dizziness.
• Shortness of breath and difficulty breathing.
• Unexplained anxiety, weakness or fatigue.
• Palpitations, cold sweat or paleness.

Stroke Warning Signs

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.
• Sudden confusion, trouble speaking or understanding.
• Sudden trouble seeing in one or both eyes.
• Sudden trouble walking, dizziness, loss of balance or coordination.
• Sudden, severe headache with no known cause.

STROKES AND HEART ATTACKS CAN BE FATAL! IF YOU ARE EXPERIENCING THESE SYMPTOMS CALL 911.

Diet or Eating Disorder

Dieting is about losing a little bit of weight in a healthy way.
Eating Disorders are about trying to make your whole life better through food and eating (or lack of).


Dieting is about doing something healthy for yourself.
Eating Disorders are about seeking approval and acceptance from everyone through negative attention.


Dieting is about losing a bit of weight and doing it healthfully.
Eating Disorders are about how life won't be good until a bit (or a lot) of weight is lost, and there's no concern for what kind of damage you do to yourself to get there.


Dieting is about losing some weight in a healthy way so how you feel on the outside will match how good you already feel on the inside.
Eating Disorders are about being convinced that your whole self-esteem is hinged on what you weigh and how you look.


Dieting is about attempting to control your weight a bit better.
Eating Disorders are about attempting to control your life and emotions through food/lack of food -- and are a huge neon sign saying "look how out of control I really feel"


Dieting is about losing some weight.
Eating Disorders are about everything going on in life -- stress, coping, pain, anger, acceptance, validation, confusion, fear -- cleverly (or not so cleverly) hidden behind phrases like "I'm just on a diet".








IN SHORT!- Dieting is an attempt to become more healthy in a healthy safe way. Eating disorders are about control and losing weight in quick unhealthy ways. It is a way of dealing with internal and external problems and unhealthy relationships with food.

Types of Eating Disorders

Anorexia- A disorder associated mainly with restricting calories it also can have periods of binge eating and/or purging. Both types typically occur in alternating episodes.

• Restricting Type: during the current episode of Anorexia Nervosa, the person has not regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)
• Binge-Eating Type or Purging Type: during the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating OR purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)

Bulimia- Two types of Bulimia exist usually together. Unlike anorexia, the bulimic will eat food instead of restricting. They can have periods of binging on large amounts of calories. After the binge they will use methods of removing the food from the body. Like anorexia they sometimes fast and use exercise to compensate for eating.

• Purging Type: during the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas
• Nonpurging Type: during the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas

Anorexia and Bulimia are the two main types however the line between the two are not entirely clear. People can exhibit behaviors and symptoms of both. People with these disorders are not always underweight. Many are in the average range or even overweight or obese. The disorder is just as dangerous at an obese weight as it is a severely underweight weight. 

Compulsive overeating disorder- 

People suffering with Compulsive Overeating have what is characterized as an "addiction" to food, using food and eating as a way to hide from their emotions, to fill a void they feel inside, and to cope with daily stresses and problems in their lives.

Binge eating disorder- Disorder in which a person binges on food until they are uncomfortably full.

Pica- a widely misunderstood phenomenon, is defined as a compulsive craving for eating, chewing or licking non-food items or foods containing no nutrition. These can include such things as chalk, plaster, paint chips, baking soda, starch, glue, rust, ice, coffee grounds, and cigarette ashes. It may sometimes be linked to certain mineral deficiencies (i.e., iron or zinc). Pica can be associated with, developmental delays, mental deficiencies and/or a family history of the disorder. There may be psychological disturbances that lead to Pica as well, such as conditions in which a child lives in a low-income or poor family, or who lives in an environment of little love and support.

Prader-Willi Syndrome- a congenital condition (present at birth) and is believed to be caused by an abnormality in the genes that occurs (though statistically it does not seem to run in families). Children born with Prader-Willi Syndrome may have early feeding difficulties that lead to tube feeding, and often have a degree of behavioral and/or mental problems (some severe).

The person with Prader-Willi Syndrome has an insatiable appetite. This can lead to obesity, stealing, and eating pet foods and items that are spoiled. This continuous appetite is caused by a defect in the hypothalamus -- a part of the brain that regulates hunger -- that causes the person to never actually feel full. There may be sleep disorders and abnormalities, bouts of rage, a higher threshold for pain, compulsive behaviors such as picking at the skin, and even psychoses.

Night eating syndrome-Here's the Merck Manual definition and conclusion about treatment. (1982 ed.) p.917:

"Night Eating Syndrome consists of morning anorexia, evening hyperphagia (abnormally increased appetite for consumption of food frequently associated with injury to the hypothalamus) and insomnia. Attempts at weight reduction in these 2 conditions, (referring to bulimia as well), are usually unsuccessful and may cause the patient unnecessary distress."

The authors call both syndromes, "deviant eating patterns apparently based on stress and emotional disturbance..."

Sleep Eating Disorder- typically falls into the category of Sleep Disorders, though it is a combined sleep-eating problem. Sufferers tend to be overweight and have episodes of recurrent sleep walking, during which time they binge on usually large quantities of food, often high in sugar or fat. Most often, sufferers do not remember these episodes, putting them at great risk of unintentional self-injury.

BDD, or Body Dysmorphic Disorder- a preoccupation or obsession with a defect in visual appearance, whether that be an actual slight imperfection or an imagined one. Some example of this would be obsessing to the point of severe depression (sometimes including thoughts about or attempts at suicide) over physical attributes such as freckles; a large nose, blotchy skin, wrinkles, acne, scarring. Though the preoccupation can include any part of the body, areas of the face and head, specifically the skin, hair and nose, are most common. This disorder is almost always present in anorexia and bulimia.

It should be noted that Orthorexia Nervosa is not a condition that a physician will diagnose, as there is no clinical guideline for this disorder. It is a condition that has been observed as an extreme pattern of dietary purity and has not yet been defined under the clinical diagnostic manual (DSM-IV).

Orthorexia Nervosa- an obsession with a "pure" diet, where it interferes with a person's life. It becomes a way of life filled with chronic concern for the quality of food being consumed. When the person suffering with Orthorexia Nervosa slips up from wavering from their "perfect" diet, they may resort to extreme acts of further self-discipline including even strictor regimens and fasting."This transference of all of life's value into the act of eating makes orthorexia a true disorder. In this essential characteristic, orthorexia bears many similarities to the two well-known eating disorders anorexia and bulimia. Where the bulimic and anorexic focus on the quantity of food, the orthorexic fixates on its quality. All three give food an excessive place in the scheme of life." (Steven Bratman, M.D., October 1997)

As noted by BeyondVeg.com, Orthorexia Nervosa should only be characterised when it is in the long-term (paying attention to healthy food for a few weeks where it becomes a normal and healthy routine not obsessed over, would not be considered a disorder), when it has a significant negative impact on an individual's life (thinking about food to avoid the stresses of life, thinking about how food is prepared to avoid negative emotions, thinking about food the majority of each individual's day), and where food rituals are not better explained by something like religious rites (such as in the Orthodox Jewish religion).

It should be noted that Bigorexia is not a condition that a physician will diagnose, as there is currently no clinical guideline for this disorder. It is a condition that has recently been observed by several psychiatrists as the "opposite of Anorexia".

Bigorexia-Found typically in body-building circles and known as muscle dysmorphia or reverse Anorexia, Bigorexia is a condition in which the sufferer is constantly worried that they are too small. This goes beyond the typical body-building gym-goer, and transcends into dangerous realms when men and women are willing to go to all lengths to increase muscle mass. Dr. Harrison Pope, of the McLean Hospital, says, "there's nothing inherently pathological about being an avid gym-goer, but it shouldn't take over your life." In likening Bigorexia to Anorexia he comments, "They are both disorders of body image, the preoccupations simply go in opposite directions."

Muscle dysmorphia isn't as acutely life-threatening as starving yourself, Pope says, but its sufferers are more likely to take other risks with their health, such as using steroids or other bodybuilding drugs. One muscle dysmorphic woman was hospitalized for kidney failure, brought on by her high-protein diet and steroid use. Within months of her release from the hospital, she was back on the drugs and unhealthy diet.

Compulsive Exercise- sufferers usually have episodes of repeatedly exercising beyond the requirements of what is considered safe, will find time at any cost to do the exercise (including cutting school, taking off from work, hiding in the bathroom and exercising, etc.). The main goal of the exercise can be burning calories and "relieving the guilt" from just having eaten or binged, or to give us "permission" to eat. (i.e., "I can't eat unless I've exercised or know I will exercise.")