1. Mehler PS. “Medical Complications of Eating Disorders During Pregnancy.” In: Care of the Pregnant Patient ACP Press, Barbour L (ed.), Philadelphia; 2000.

Eating Disorders (e.g., anorexia nervosa and bulimia nervosa) are on the rise in our society and cause the highest mortality and medical morbidity of any psychiatric disorder. Medical complications of these two disorders are ubiquitous and can affect every system of the body. While the plight of an emaciated, malnourished patient (i.e., anorexic) is apparent by observation alone, diagnosis of bulimia can be more challenging.

Adolescence is a period of psychosocial change that is often perplexing for both teens and their parents. The rapid physical changes that occur at this time lead adolescents to become preoccupied with their body image. Adolescents may become preoccupied with themselves, uncertain about their appearance, compare their bodies with those of other teens, and become increasingly interested in sexual anatomy and physiology.Anorexia nervosa is an eating disorder that disproportionately affects adolescents and has its origin, at least partially, in this preoccupation with body image.

Patients with anorexia nervosa of the restricting (AN-R) and purging (AN-P) subtypes were studied to determine if there was a differential effect on leptin levels. It was hypothesized that the AN-P subgroup would have elevated leptin compared to the AN-R subgroup. Fasting plasma and anthropormorphic measurements were collected from 8 women with AN-R and 5 with AN-P. Eleven women served as controls.

1. Mehler Philip S. 'Medical Complications of Eating Disorders.' New England Journal of Medicine 341(8):614-615, 1999. (Ltr)

Osteoporosis, the loss of bone mineral density, is an important complication of anorexia nervosa. Often, the progressive diminution in skeletal integrity results in an irreversible weakening of bones despite recovery from anorexia nervosa. This can ultimately result in painful fractures in the spine and hip. Preventive therapy as well as medicinal interventions are available to stop the inexorable loss of bone mass associated with anorexia nervosa. Early diagnosis must be emphasized because of the serious health implications of osteoporosis.

Anorexia nervosa is a chronic disorder characterized by the patient's refusal to maintain body weight and a myriad of medical complications. Two frequently cited and poorly understood complications are hypercholesterolemia and hypercarotenemia. We therefore measured fasting cholesterol and beta-carotene levels in a cohort of moderately severe anorectics. Method: All subjects were female and met DSM-IV criteria for anorexia nervosa. Lipid profiles and beta-carotene levels were determined in 23 female anorexics.

Constipation is a common complaint among all eating disorder patients. It is variably defined by patients and staff, often leading to false expectations. A limited search for organic causes is indicated, as is a thorough review of the patient's medication history. Forewarning and education are cornerstones of the treatment process. Other medical therapies are also reviewed.

Read the full article in the Eating Disorders: The Journal of Treatment and Prevention.

Of the entire gamut of psychological disorders treated by clinicians, eating disorders are the ones most frequently punctuated by concomitant medical complications. Many of these are not serious, but a distinct number of these complications have serious ramifications. Herein, we discuss some of the most frequently encountered medical issues during the treatment of bulimics and anorectics.

Read the full article in Eating Disorders: The Journal of Treatment and Prevention.

Anorexia nervosa can have a devastating outcome. There is a high rate of treatment failures and recidivism among anorectic patients. Further, it is generally accepted that unless one can effectuate a significant weight gain in these patients, treatment is even more likely to fail. Total parenteral nutrition (TPN) offers an alternative mode of treatment to be used in the armamentarium to successfully treat anorexia nervosa.