Medical complications of anorexia nervosa and bulimia nervosa.
OBJECTIVE
This review focuses on recent publications concerning medical complications in patients with eating disorders, including anorexia nervosa and bulimia nervosa.


RESULTS
Recent literature continues to reflect that multiple organ systems are frequently affected by eating disorders. The literature underscores the frequently cited risk of premature death in those with anorexia nervosa. A plethora of dermatologic changes have been described, some signaling serious underlying pathophysiology, such as purpura, which indicates a bleeding diathesis. Much of the literature continues to delineate the fact that diabetic patients with eating disorders are at high risk of developing diabetic complications. Gastrointestinal complications can be serious, including gastric dilatation and severe liver dysfunction. Acrocyanosis is common, and patients with anorexia nervosa are at risk of various arrhythmias. Low-weight patients are at high risk for osteopenia/osteoporosis. Nutritional abnormalities are also common, including sodium depletion and hypovolemia, hypophosphatemia and hypomagnesemia. Resting energy expenditure, although very low in low-weight patients, increases dramatically early in refeeding.


CONCLUSIONS
Medical complications are common and often serious in patients with eating disorders, particularly those with anorexia nervosa.
Mitchell
James E
JE
Department of Clinical Neuroscience, University of North Dakota School of Medicine and the Neuropsychiatric Research Institute, Fargo, North Dakota 58103, USA . mitchell@medicine.nodak.edu
Crow
Scott
S
D000856:Anorexia Nervosa / Q000150:complications* / Q000401:mortality; D001847:Bone Diseases / Q000209:etiology; D052018:Bulimia Nervosa / Q000150:complications* / Q000401:mortality; D002318:Cardiovascular Diseases / Q000209:etiology; D004700:Endocrine System Diseases / Q000209:etiology; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D020738:Leptin / Q000097:blood; D008171:Lung Diseases / Q000209:etiology; D009748:Nutrition Disorders / Q000209:etiology; D012871:Skin Diseases / Q000209:etiology
D020738:Leptin