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What Are the Risks of Untreated Eating Disorders?

Having an eating disorder such as anorexia nervosa, bulimia nervosa, or binge eating disorder, or ARFID )Avoidant Restrictive Food Intake Disorder)is more than just a troubled relationship with food; it’s a serious mental illness that must not be left alone. Without treatment, according to some studies, the fatality rate for people with eating disorders can reach 20%. That’s why, if you or a loved one has received a diagnosis of an eating disorder, seeking out a quality treatment that can care for someone who has one of these illnesses is essential. People with eating disorders still face some stigma driven by the idea that they choose to suffer; eating disorders are not a lifestyle choice but are serious medical conditions that can endanger a person’s life if allowed to continue. Each major kind of eating disorder comes with different risks – let’s find out why each kind of eating disorder necessitates treatment and what can happen if they aren’t addressed.

Risks of Anorexia Nervosa

Anorexia nervosa is the most dangerous mental health disorder of any type, with a fatality rate higher than any other mental health disease, including major depression. Anorexia nervosa is characterized by restrictive eating, distorted body image, and severe weight loss. Many people become medically deemed underweight, although in cases of atypical anorexia nervosa the individual may not become underweight. In addition to the restriction of food intake, people with anorexia nervosa often engage in obsessive exercise, which can put incredible stress on the body and cause physical injuries.

Anorexia nervosa also comes with an extremely distorted body image – where they continue to see themselves as obese even when they are severely underweight or even starving. The combination of emotional, psychological, and physical complications make anorexia nervosa treatment a complex endeavor; most treatment centers employ psychologists, psychiatrists, nutritionists, and counselors, who all work in conjunction to treat each case.

People who have anorexia nervosa run the risk of death, brain damage, multi organ failure, infertility, heart damage, anemia, osteoporosis, liver, and other organ damage, and indices a much higher rate of suicide than the general population. Other problems that can come with an anorexia nervosa diagnosis include drying and yellowing of the skin, brittle nails, and hair, constipation, constant fatigue, small, fine hairs growing all over the body (lanugo), reduced body temperature, and feeling cold all the time, and lower blood pressure and lowered vital signs.

Risks of Bulimia Nervosa

Bulimia nervosa is another severe mental health disease that comes with body image distortions and behavioral changes designed to lose weight or prevent weight gain. Rather than restricting food intake like with anorexia nervosa, people with bulimia nervosa will regularly engage in binge eating episodes, in which they eat large amounts of food in a short period, then counteract that intake by purging it. This most commonly comes in the form offorcing themselves to vomit, but It can manifest as taking excessive laxatives or diuretics, excessively exercising, or severely restricting their food afterward. This purging eating disorder may lead to two or more of the above behaviors to compensate for their binge eating episodes.

Bulimia nervosa is often triggered by a desire to lose weight, but the stereotypical image of a person with an eating disorder (underweight or gaunt) is not a given with this disorder. Many people with bulimia nervosa don’t lose significant amounts of weight or become medically underweight. Because of this, bulimia nervosa sufferers might switch between anorexia nervosa behaviors and bulimia nervosa behaviors, creating a cycle of weight fluctuations that compound the already dangerous nutritional deficiencies cause by each disorder.

Specialized eating disorder recovery and treatment programs are essential for acute cases of bulimia nervosa,as it can cause many dangerous physical consequences and is known to be relapse-prone. In some cases, the loss of electrolytes caused by self-induced vomiting can be so extreme that they can have a stroke or heart attack. Many of the same nutritional deficiencies associated with anorexia nervosa can occur with bulimia nervosa, which can interfere with the body’s ability to heal and can also affect cognitive functions. Bulimia nervosa also comes with various ailments related to repeated vomiting, like sore throat, sore jaw and lymph nodes, and decaying teeth. There may also be acid reflux and damage to the intestines. Like any eating disorder, bulimia nervosa can trigger psycho social difficulties; a person’s social life and work can be affected by self-isolation and anxiety in situations where food is present.

Risks of Binge Eating Disorder

Binge eating disorder is defined as a person compulsively and repeatedly eating a large amount of food in a very short time – unlike bulimia nervosa, there is no compensatory purging behavior. The binge-eating episodes are normally kept secret because of the feelings of guilt and shame that come with them, and because the individual often publicly “on a diet” – in fact, they often try to lose weight with little or no success. Although people with this disorder are not usually underweight, and often tend to be overweight, they often experience body image distortions just as with anorexia nervosa and bulimia nervosa.

Binge eating disorder challenges many stereotypes about eating disorders. The idea of a thin, white woman or adolescent being the typical eating disorder sufferer is belied by the fact that BED is the most common eating disorder, and people with the disorder are seldom underweight. Binge eating disorder also affects men almost as often as women and tends to occur more often in adulthood rather than adolescence. However, feelings of body dissatisfaction and compulsion to engage in disordered eating behaviors show that binge eating disorder shares many aspects with other, more well-known types.

People with binge eating disorder have many health risks that come with obesity. They include difficulty with movement, diabetes, high blood pressure, stroke, and heart attack. Without specialized binge eating disorder treatment, the behaviors that lead to obesity can continue unabated, and the health risks compile. Arguably more important, the psychological distress associated with binge eating disorder can worsen over time. BED can trigger or worsen co-occurring disorders like depression and anxiety, which impact the person’s ability to maintain healthy relationships. In extreme cases, social isolation and even suicidal ideation pose risks to their wellbeing.

Risks of ARFID

Avoidant Restrictive Food Intake Disorder (ARFID), which was previously known as Selective Eating Disorder, is a bit of an outlier from the other disorders mentioned here, although its physical and psychological risks are just as prevalent. It’s different because its causes do not center around negative body image or a desire to lose weight, and that it is as common in small children as it is in adolescents and adults. Despite these differences, ARFID can be just as destructive as the rest of these disorders and can be just as difficult to overcome.

Like binge eating disorder, ARFID is a relatively new addition to the official diagnostic manual for mental health disorders – it was added in 2013 to the DSM-V. It’s characterized by strict avoidance of certain foods or food groups. If these foods are present at meals, the individual normally feels great fear or anxiety and may not be able to stay at the table or eat the other foods. Unlike other eating disorders, where the restriction is based on avoiding weight gain, ARFID’s restrictions are based on fear of harm if the food is eating. For example, a person with ARFID may avoid eating steak for fear of choking. Or they may not eat seafood for fear of getting food poisoning. These are just examples; ARFID can cause people to avoid a food type for many reasons, many of which are irrational.

Although the causative factors may be different from those of anorexia nervosa, the physical consequences can be the same. Extreme avoidance of many foods can cause an ARFID sufferer to quickly lose weight or have difficulties maintaining an appropriate weight for their age and height. There is also a great risk of nutritional deficiencies and imbalances which can cause various illnesses such as anemia, low blood pressure, and bone diseases. ARFID also causes intense psychological distress and interferes with a person’s ability to socialize. This leads to increased isolation and stress in social situations.

Resources for Eating Disorder Treatment

This is only a partial list of eating disorders and their negative consequences. There are other forms, and they are often just as dangerous. If you notice unusual eating habits or body image issues in yourself or a loved one, the first thing to do is research the symptoms and see if there is cause for concern. The National Eating Disorder Association’s archive is a great place to start – the information there is clear and complete. Our blog is frequently updated ad touches on a variety of eating disorder-related topics as well. Knowing what to look for will help everyone concerned in starting treatment – which is key because early intervention has been proven time and again to provide the best recovery outcomes.

Treatment itself will be a combination of psychological and nutritional rehabilitation. We won’t sugarcoat it; eating disorder treatment is a difficult journey, with setbacks and breakthroughs both part of the process. Eating disorder treatment professionals will use a variety of therapeutic techniques to increase objectivity and mindfulness (to better correct body image distortions and combat compulsive urges to use disordered behaviors), as well as helping their clients process their emotions. Past trauma, a common trigger for eating disorders, is normally a major focus as well. Mindful movement and nutritional training are part and parcel of eating disorder treatment as well. They all combine to make a complex yet effective treatment plan.

Despite all the possible negative consequences of untreated eating disorders, don’t lose hope. Eating disorder treatment professionals have the knowledge of decades of combined work at their disposal. They can help people heal, mentally, emotionally, and physically. If you or a loved one is struggling, don’t wait. Get started on the recovery journey today.


Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.