Key Points
- Malnutrition damages every organ system.
- Terms such as Goal or Ideal Weight or range often are talking about the minimum #, and may be too low for good health for many individuals.
- BMI does not take into account gender differences and may be too low for good health.
Central Nervous System (Brain)
- May show signs of cognitive impairment on neuropsychological testing or in performing daily tasks.
- Poor concentration, depressed and irritable mood.
- Nero-imaging studies (CT, MRI) show changes in brain can occur fairly early in AN.
- Reduction in the size of brain issue (grey and white tissue)
- Weight restoration brings white matter volume back, however grey matter loss may persist.
Cardiovascular
- Loss of cardiac muscle (wasting) occur early in the course of AN, with decreased heart size and thickness of walls, potentially reducing heart’s ability to pump oxygenated blood to body.
- Generally reversible, but risk in acute stages.
- Slow heart rate (bradycardia), >35-40bpm for adults, and > 50bpm for adolescents
- Decreased blood pressure
- Restricting fluids may cause orthostatic (low volume of fluid inside arteries) may cause fainting.
Endocrine/Metabolic
- Fatigue, cold intolerance, excessive urination or involuntary vomiting may be related to changes in hormonal (endocrine) system.
- Generally, electrolyte problems occur in those who purge by vomiting or use of diuretics or laxatives (or severely restrict fluids).
- Having “normal labs” is not in itself indicative of good health.
- Most of the serious complications of AN are not detected by blood tests
Gastrointestinal
- Bloating, abdominal pain, constipation
- May result from delayed emptying time of the stomach, or slowed down digestive processes
- Colonic transit times normalize in a few weeks with nutritional restoration.
Reproductive
- Loss of menstrual periods increases the life-long risk of bone problems
- Loss of periods from AN different than with menopause
- Birth control pills will not protect bone health, and should not be used in AN
Renal (kidney)
-
Risk of kidney failure with severe fluid restriction (laxative or diuretic use)
Skeletal
- Excessive exercise can cause stress fractures and bone pain
- Most serious in adolescence when should be developing peak bone mass
- Damage often permanent, starts early
- DEXA scan in first 6 months at low weight
- Medications used in menopausal women for osteoporosis not effective for AN
- Weight restoration only way to stop progression of bone loss.
Skin and Hair
- Hair loss common
- Lanugo on body and face (fine, downy hair)
All material © 2011-2013 Rhonda Overberger. If you wish to share my original, copyrighted material, please include my name and www.rhondahelp.com as the source. Thank you.