It’s a myth that the effects of eating disorders aren’t as dangerous as the effects of other mental health conditions. Unfortunately, health complications related to eating disorders can be fatal.
However, early intervention markedly improves treatment outcomes, which is one reason to ensure people with eating disorders receive a prompt diagnosis and access to treatment.
Mortality Rates in People With Eating Disorders
Studies report varying death rates from eating disorders, but there are common findings. It’s estimated that every 52 minutes, someone dies from a complication of an eating disorder—that’s 10,200 deaths per year in the United States.
Anorexia nervosa may have the highest mortality rate of eating disorders that have been studied. One study reports that people with anorexia nervosa experienced a standardized mortality rate of 5.35—that is, they were about five times more likely to have died over the study period than age-matched peers in the general population.
People with bulimia nervosa and binge eating disorder had a standardized mortality rate of 1.5 compared to their peers who didn’t have eating disorders. A meta-analysis found that the standardized mortality rate was 1.92 for the diagnosis of other specified feeding and eating disorder, formerly known as eating disorder not otherwise specified (EDNOS).
Mental Health and Eating Disorders
The link between eating disorders and other mental illnesses is strong. In some cases, the symptoms of a pre-existing condition worsen because of an eating disorder. But even without a pre-existing condition, a person’s mental health is negatively affected by the progression of an eating disorder.
The following conditions commonly coexist with eating disorders:
Someone with an eating disorder may find it difficult to maintain social relationships (especially if they are hiding their eating disorder from loved ones), keep their jobs, go to school, and function in their everyday life. They may feel stressed and alone as a result of their eating disorder. They may also feel guilt and shame.
There is an increased risk of suicidal behavior linked with anorexia nervosa, bulimia nervosa, and binge eating disorder. Someone with an eating disorder and another psychiatric illness may be at an increased risk of suicidal behavior.
Causes of Eating Disorder-Related Deaths
There are a number of medical complications that can arise from eating disorders, many of which are fatal. In addition, the increased risk of suicide that people with eating disorders face is another cause of eating disorder-related deaths.
Cardiovascular Complications
Cardiac-related issues cause one-third of all deaths in patients with anorexia. Common cardiac complications that occur among people with anorexia include bradycardia (slow heart rate) and hypotension (low blood pressure).
Both anorexia and bulimia are linked with a greater risk of heart arrhythmia (a heartbeat that is too fast or too slow) and congestive heart failure.
Bulimia and binge eating disorder are linked with a greater risk of cardiovascular disease, which causes one in every four deaths in the United States.
Anxiety and stress, which many people with eating disorders experience, are also linked with an increased risk of cardiovascular disease.
Binge eating disorder may cause excess weight and obesity, at which point a person also has a higher risk of developing cardiovascular disease and high blood pressure.
Dehydration
Dehydration is a significant risk that people with anorexia and bulimia face. Dehydration can cause electrolyte imbalances in the body, altering levels of elements like calcium, potassium, sodium, and magnesium.
Dehydration is often responsible for the cardiac issues people with eating disorders face, like low blood pressure and heart arrhythmia.
Electrolyte imbalance is the most common cause of sudden death in people who die from bulimia nervosa, as purging drastically affects electrolyte levels in the body.
Diabetes
Though not recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM), “diabulimia” is a term used to refer to people with type 1 diabetes who purposely don’t use enough insulin in an effort to lose weight. However, this is a dangerous and potentially fatal practice.
In addition, binge eating disorder may cause type 2 diabetes, which is the 9th leading cause of death in the United States.
Malnutrition
Malnutrition is when the body doesn’t receive adequate vitamins, nutrients, and minerals to keep functioning properly. Malnourishment causes a loss of muscle mass (including cardiac muscle mass) and decreased respiratory and gastrointestinal functioning. People with anorexia can experience malnutrition and starvation, which can be fatal.
People with binge eating disorder and bulimia can experience malnutrition as well. Malnutrition is linked with long-term health problems like diabetes and heart disease, which can be fatal. There are also negative mental health effects linked with malnutrition such as depression and anxiety.
Refeeding Syndrome
Refeeding syndrome can occur in people with anorexia who receive artificial feeding to treat malnutrition. In some cases, the drastic shift in electrolytes from refeeding causes metabolic changes that result in seizures, respiratory failure, and death.
Suicide
Suicide is a major concern for those with all types of eating disorders. One study found that suicide is the second leading cause of death for people with anorexia and that the risk of suicidal behavior is increased for those with bulimia and binge eating disorder compared to the general population.
On average, people with anorexia are 18 times more likely to die by suicide and people with bulimia are seven times more likely.
Treatment Types
Fortunately, there are many options when it comes to treating eating disorders. The appropriate treatment options depend on a variety of factors including the type of eating disorder an individual has, how their condition has progressed, what a doctor recommends, and what insurance will cover (or what they are able to afford out of pocket).
Hospitalization
In some cases, people with anorexia require a nasogastric tube, which is a tube inserted through the nose that will administer necessary nutrients to prevent starvation.
Someone who is in immediate danger as a result of an eating disorder (for instance, if they’re experiencing dehydration, malnutrition or starvation, arrhythmia, or heart failure) should get to an emergency room as soon as possible.
Doctors and nurses in a hospital are able to provide 24-hour supervision for those with eating disorders who may require it.
Treatment Centers
There are different types of treatment centers for eating disorders. Some provide outpatient care, which means you live at home, but you go to the treatment center for counseling.
Depending on the type of program you’re in and the level of care you need, you might go once a week for a few hours, or you might go every day for multiple hours, until symptoms improve.
Residential treatment centers provide inpatient care or 24-hour supervision. These centers are for people who require care around the clock, but who are medically stable.
Treatment centers usually provide a team of specialists to work on each person’s case. For instance, your team may include a medical doctor, psychologist or psychiatrist, registered dietician, and social worker.
Goals of treatment include providing education on nutrition, preventing medical complications, reducing eating disorder behaviors (such as binging, purging, or restricting), and restoring weight, if necessary.
Therapy
The following types of therapy are often used to treat eating disorders:
Cognitive behavioral therapy (CBT): A therapist will help a patient understand the underlying thoughts and attitudes behind their eating disorder behaviors. They will teach healthy coping mechanisms to help a person overcome dangerous eating behaviors.
Family-based treatment (FBT): FBT is often used for adolescents with eating disorders. Parents and caregivers are taught how to support their children at mealtime by deciding what they will eat and encouraging them to eat.
Group therapy: Being in a group setting can help someone with an eating disorder talk about their experiences and learn from their peers. Group therapy may provide a person with strong interpersonal relationships that can help during recovery.
Interpersonal psychotherapy (IPT): Along with CBT, IPT is considered one of the “most established” treatments for eating disorders. IPT can help a person gain control over their eating behaviors and rituals.
One study found that adolescents with anorexia who had been ill for more than three years had a poor response to family and individual therapy. Research has found that over time, anorexia has the potential to damage a still-developing brain, which may make it more difficult to treat the eating disorder.
These findings suggest that treatment outcomes for adolescents with anorexia may be more successful if administered within the first three years of the condition. However, it’s still important that a person seeks treatment at any stage of their eating disorder.
Medication
There aren’t medications approved by the Food and Drug Administration (FDA) to treat anorexia, but a healthcare professional may prescribe off-label the following antidepressants to treat depression or anxiety in people with anorexia: Prozac (fluoxetine), Celexa (citalopram), or Zoloft (sertraline).
These antidepressants are selective serotonin reuptake inhibitors (SSRIs), which increase serotonin levels in the body, promoting feelings of well-being and regulating mood and anxiety.
Prozac is approved by the Food and Drug Administration (FDA) to treat bulimia and binge eating disorder. This antidepressant may help to reduce binge-purge episodes.
Vyvanse (lisdexamfetamine) is a stimulant that is commonly prescribed for attention-deficit/ hyperactivity disorder (ADHD), but it is also FDA-approved for binge eating disorder. It works by increasing norepinephrine and dopamine in the body, which may help regulate overeating.
Finding Support
If you are living with an eating disorder, talk to a primary care physician or a mental health professional such as a therapist. You deserve to receive adequate treatment for your eating disorder.
A therapist can review your options with you, and together, you can decide the best course of treatment. A therapist may also recommend you meet with a psychiatrist if you could benefit from taking medication for your eating disorder or an underlying mental health condition.
It is common for people with eating disorders to believe that their behaviors surrounding food are not serious. If someone you know is struggling with an eating disorder, you may be able to encourage them to seek help.
If you or a loved one are experiencing severe physical or mental health symptoms related to an eating disorder, go to the emergency room and seek immediate care.
Eating Disorder Prevention
The first step toward eating disorder prevention is education. Learning about different types of eating disorders can help diminish the stigma that people with eating disorders face.
Avoid making comments about other people’s bodies, what people eat, and how much of it they eat.
Acknowledge the weight stigma in society, where people in thinner bodies may be more prone to idealization and people in larger bodies more prone to criticism.
Try not to call foods “good” or “bad,” which implies there should be guilt or shame surrounding “bad foods.” While it’s important to acknowledge which foods are more nutritious, try not to be hard on yourself or others for indulging in less nutritious foods.
Parents and caregivers can try keeping an open dialogue on food, weight, and body image with their families. Remember, kids notice if you criticize yourself based on your weight or your eating habits. Celebrate yourself and others for talents, unique qualities, and individuality (not solely for appearance).
Eating disorder prevention programs such as the National Eating Disorder Association’s The Body Project have been found to be effective in preventing eating disorders among young women in high school and college. The Body Project, for instance, helps participants achieve body satisfaction and challenge society’s thin ideal.
Healthcare professionals should also be held accountable for recognizing the warning signs and risk factors for eating disorders in all of their patients, especially people of color, people who are overweight, and men—groups that may be overlooked or face even greater stigma when it comes to eating disorder diagnoses.
Speak to a healthcare professional about potential triggers, such as getting weighed in at the doctor’s office. (For example, you may request that the physician’s assistant doesn’t read the number out loud.)
Having an open dialogue—with loved ones, health professionals, and yourself—is important.
A Word From Verywell
If you have an eating disorder (or you’re concerned you are developing one), try to reach out to a doctor or a mental health professional as soon as possible. If you have a loved one with an eating disorder, gently encourage them to seek help. Left untreated, the symptoms of eating disorders often worsen. But eating disorders are treatable, and you can recover.
