Cardiovascular Complications in Eating Disorders
Eating disorders are serious, life-threatening illnesses that affect every system of the human body. The cardiovascular system is comprised of the heart and blood vessels and is one of the most important systems in the body. Cardiovascular complications in eating disorders may occur as a result of the malnutrition and electrolyte disturbances commonly associated with these disorders.
By: Valisha Barclay
Our hearts help to distribute oxygen throughout our body and keep us alive. In order for it to function properly, we have to consider how well we nourish it. Nutrition is particularly important in providing fuel for our body, especially our brain, and our heart. When an eating disorder disrupts this process, a variety of health consequences may arise, some potentially fatal.
Anorexia Nervosa
Most deaths in those suffering from Anorexia Nervosa are caused by heart failure. This heart failure occurs as a result of malnutrition from inadequate food intake. Because the body is receiving less fuel to keep its organs in optimal working condition, the heart rate slows down and blood pressure lowers. Consider that our body has a basal metabolic rate — the baseline rate at which our body uses energy to complete its functions throughout the day. When we have less fuel available, this rate will decrease. This is because our body will conserve most of the energy for the essential organs such as the brain. The heart rate will decrease in order to use less energy.[1,2]
In Anorexia Nervosa, the muscles of the heart will atrophy as a result of inadequate nutrients. If there is insufficient protein available for the body to use through food, it will start to break down the muscle already in the body. Our heart is a muscle that, unfortunately, is not exempt from being broken down as well. Another potential structural change in the heart caused by malnutrition is a change in left ventricle size. Our hearts have two ventricles and the left ventricle is responsible for pushing the blood into the rest of our body. If it changes in shape, it can disturb the natural distribution of blood. Changes in ventricular shape can also lead to valve abnormalities. The valves in our heart help to keep the ventricles open and closed. There have been some cases of pericardial effusion. This is a buildup of fluid around the heart. This can particularly problematic because the excess fluid can cause irregular heartbeats.[2,3]
Bulimia Nervosa
In Bulimia Nervosa, repetitive vomiting (purging) leads to less liquid in the body which can lead to low blood pressure, otherwise known as hypotension. Fainting is a common symptom of low blood pressure. The loss of water through purging can lead to fluctuating concentrations and imbalances of electrolytes in the body, including potassium. When potassium levels drop (hypokalemia), this can cause arrhythmias of the heart that can be potentially fatal.[4]
If medications that induce vomiting are used, there is a risk of cardiomyopathy. This is a condition that makes it harder for the heart to pump blood through the body. In addition to this, the valves in the heart can also be affected. In bulimia nervosa, there can be times when the mitral valve in the heart does not close properly. Although this condition is not life-threatening, it can lead to dangerous consequences over time.[4]
Binge Eating Disorder
Although the research on binge eating disorder is limited, there is evidence to show that it can result in high blood pressure, high levels of triglycerides, increased risk of type 2 diabetes, and high cholesterol, all of which are associated with cardiovascular complications.[5]
Early recognition and treatment intervention is paramount for avoiding the dangerous cardiovascular complications associated with eating disorders. At BALANCE eating disorder treatment center, our compassionate, highly skilled team of clinicians is trained in diagnosing and treating the spectrum of eating disorders, including anorexia, bulimia, binge eating disorder, compulsive overeating, and other disordered eating behaviors and body image issues.
Our admissions team would be happy to answer any questions you may have about our programs and services. Book a free consultation call with our admissions team below or read more about our philosophy here.
This post was written by BALANCE Dietetic Intern, Valisha Barclay.
Valisha is a dietetic intern at NYU who is currently working on her Masters in Clinical Nutrition. She completed her undergrad at Hunter College and works as a Care Coordinator at Memorial Sloan Kettering Cancer Center with patients undergoing bone marrow transplants. She has also worked with patients with gynecological cancers including ovarian, uterine and cervical cancers for three years. She has a passion for learning and providing support and care. She also has a passion for food, nutritionally and culturally. Outside of school and work, she enjoys cooking with her toddler and hopes to travel and explore the world through food.
Resources
1. Brown, J., Mehler, P., & Harris, R. (2000, March). Medical complications occurring in adolescents with anorexia nervosa. Retrieved October 30, 2020, fromhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1070803/
2. MJ;, S. (n.d.). Cardiovascular complications of anorexia nervosa: A systematic review. Retrieved October 30, 2020, from https://pubmed.ncbi.nlm.nih.gov/26710932/
3. Sardar MR, Greway A, DeAngelis M, et al. Cardiovascular Impact of Eating Disorders in Adults: A Single Center Experience and Literature Review. Heart Views. 2015;16(3):88-92. doi:10.4103/1995-705X.164463,
4. Mehler, Philip S.; Crews, Cynthia; and Weiner, Kenneth, "Bulimia: Medical Complications" (2004). Nursing Faculty Publications. Paper 1. http://digitalcommons.longwood.edu/nursing_facpubs/1
5. On, P., & McCallum Place. (2018, March 15). Cardiovascular Complications of Eating Disorders. Retrieved October 30, 2020, from https://www.mccallumplace.com/about/blog/cardiovascular-complications-eating-disorders/