Someone dies from an eating disorder every 52 minutes in the United States. Some of those deaths are due to cardiovascular complications.

“The heart is severely affected by weight loss and malnutrition,” said Dr. Philip Mehler, founder and medical director of the ACUTE Center for Eating Disorders and Severe Malnutrition in Denver. “The more severe the disorder, the more likely you are to suffer cardiac complications.”

Common eating disorders include anorexia and bulimia, both of which involve obsession with weight and distorted body image. People with anorexia may avoid or severely restrict food, or exercise obsessively. People with bulimia usually purge after binge eating by vomiting or using laxatives or diuretics. Some people with anorexia also have bulimia.

Two more recently defined eating disorders are bulimia nervosa and avoidant/restrictive food intake disorder, which affect eating behaviors but do not include obsessions with body image.

Eating disorders can cause changes in the heart, which increases lifelong cardiovascular health risks. This is primarily due to malnutrition in people with anorexia and electrolyte imbalances in people with bulimia.

Eating disorders can lead to a variety of cardiovascular problems, from slow heart rate to heart failure, says Dr. Riti Patel, a cardiologist at Lankenau Heart Institute Main Line Health in Philadelphia. Stated.

“When these things happen, the eating disorder becomes much more serious,” she says.

Mehler, who is also a professor at the University of Colorado School of Medicine, said different eating disorders affect the heart differently. In people with anorexia, malnutrition and weight loss can cause the heart muscle to contract and slow the heart rate. This is a condition known as bradycardia, where your resting heart rate is less than 60 beats per minute. Loss of appetite can also cause other abnormal heart rhythms.

“Restricting food intake often causes a decrease in heart rate, regardless of size,” said Dr. Jennifer Gaudiani, founder and medical director of the Gaudiani Clinic in Denver. “This is because your body’s metabolism is slowing down.”

“The heart shrinks,” Mailer said. “Like a hibernating bear, it slows down. That can turn into a dangerous rhythm.”

“Basically, your body doesn’t want to use the extra calories to increase your resting heart rate,” Gaudiani said.

A 2023 review paper published in the Journal of Eating Disorders found that people with anorexia nervosa have the second highest risk of death among mental illnesses. Overall, people hospitalized with eating disorders may be five to seven times more likely to die than the general population, according to a 2020 Canadian study published in the British Journal of Psychiatry.

Excessive vomiting and laxative use associated with bulimia can cause electrolyte imbalances and increase the risk of heart rhythm abnormalities. Damage to the heart from bulimia can also lead to congestive heart failure and sudden cardiac death.

Some bulimics take Ipecac to induce vomiting, which can be toxic to the heart, Moeller said. It can cause cardiomyopathy (when the heart muscle becomes enlarged, thickened, and hard) and heart failure.

Gaudiani also sees many people come to her clinic with orthostatic tachycardia syndrome (POTS), which occurs when the amount of blood returning to the heart decreases when standing up, and who have eating disorders. He said he is doing so. It is characterized by symptoms such as increased heart rate, dizziness, light-headedness, and palpitations.

Eating disorders can affect people of all ages and genders, according to a 2020 report from several organizations, including Harvard University’s Strategic Training Initiative for Eating Disorder Prevention. In the United States, the highest incidence rates are found in teenage girls and women in their 20s. T. H. Chan School of Public Health and Boston Children’s Hospital. An estimated 28.8 million people in the United States will develop an eating disorder at some point in their lives.

Parents and other concerned loved ones may notice that someone is obsessing over their weight, exercising compulsively, regularly leaving the table to go to the bathroom during meals, or being underweight. Mailer says people should look out for signs such as wearing baggy clothes to cover things up.

Signs and symptoms that an eating disorder may be causing heart disease include lightheadedness, chest pain, shortness of breath, frequent nosebleeds and lack of energy, he said.

Research shows that the COVID-19 pandemic has led to an increase in eating disorders, including increased social isolation and limited access to care.

“The jury is in and it’s clear that the coronavirus has not been kind to people with eating disorder tendencies,” Mailer said. “Isolation was bad for them. They were stuck in the house all day looking at the fridge and the mirror. If all they cared about was their weight, they didn’t have to go out and interact with the world, so they focused on that. I had more time.” ”

Gaudiani said his clinic has seen an increase in people seeking treatment during the pandemic.

“There was so much out of our control that for people who tend to find stability and comfort through food, the pandemic could ignite or exacerbate eating disorders. “It became,” she said.

Patel said people with cardiovascular complications need to see a doctor for potentially life-threatening heart problems, but they must also receive treatment for eating disorders.

“You have to treat the underlying disease,” she said.

Bringing people with eating disorders back to a healthy weight may resolve the structural changes in the heart caused by malnutrition, but it must be done carefully, Mehler said. Severely malnourished people are at increased risk of refeeding syndrome, which occurs when nutrients are re-fed too quickly. It can be deadly.

It’s also important not to blame people for developing an eating disorder, Mehler said. “These are not diseases of choice. We need to be aware of this. There is a genetic component. If a parent had this disease, their child is more likely to develop it as well. Masu.”

The severity of the eating disorder will determine the type of support a person needs, she said.

“If you have a mild eating disorder, talk to your high school counselor or therapist,” says Mailer. “If it’s more serious, call an eating disorder center. And if it’s severe, go to a hospital with expertise and skill in this field.”