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)

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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.