Eating Disorders - fieldi

10 Medical Aspects of Anorexia and Bulimia
These pre-teens will fail to gain weight and will ultimately stop
growing, but they may become anorexic without actual weight loss.
Second, girls who are overweight to begin with may lose dangerous
amounts of weight and have some of the physical tolls of anorexia
but may not seem as dramatically underweight because of the extra
pounds they began with.
PHYSICAL TOLLS OF ANOREXIA
As noted earlier, anorexic patients don’t think of themselves as
starved, because they do eat some food. Their bodies, however, show
the profound effects of starvation. Loss of menstrual periods is one
of the most obvious signs of anorexia. Even more dangerous, however,
are the invisible tolls of anorexia, especially on the heart, brain,
and bones. In a single patient, tests may not demonstrate the severity
of physical compromise. However, research studies document
the unseen damage.
The impact of anorexia on the reproductive system is reflected in
the interruption of menstrual function. Girls who become anorexic
in the pre-teen or early teenage years may fail to begin menstruating
despite other signs of puberty. They may also miss crucial stages
of breast development. Older anorexics stop having menstrual periods
unless they happen to be on birth control pills. Interestingly,
periods may stop before weight loss occurs for up to one-third of
anorexics. Menstruation resumes with adequate weight restoration,
but recent data suggest a higher miscarriage rate in women who
have had anorexia. Anorexics who are not fully recovered also have
a greater incidence of infertility. If fertility treatments are used to
induce pregnancy at marginal maternal weights, there is an
increased frequency of infants with low birth weights (Abraham,
Mira, and Llewellyn-Jones 1990).
Anorexia is associated with a fulminant form of osteoporosis.
Lifelong bone strength depends on the accumulation of bone mass
during adolescence. With anorexia, bone formation is impaired and
bone breakdown is accelerated. This leads to bone thinning, which
may be seen within six months of menstrual cessation or with the
delayed onset of menstruation in premenarchal girls. It is also seen