Eating Disorders

Health Risks

Disordered eating behaviors include starvation, inadequate nutrient intake, bingeing, frequent vomiting, and abusing laxatives and diuretics. These behaviors can result in numerous negative health consequences. Cardiovascular complications such as a loss of heart muscle mass, abnormal heart beat and rhythm, and cardiac failure can result from the common ED symptoms of emaciation, electrolyte disturbances, dehydration, and weight cycling. These complications can range from being relatively benign to life threatening.

Lowered bone mineral density or osteoporosis affects a large number of individuals with anorexia due to their chronic inadequate intake of nutrients such as calcium and vitamin D. Gastrointestinal difficulties such as constipation, ulcers, tears in the esophagus, and gastrointestinal bleeding can result from purging via laxatives and vomiting. Hormone functioning can be altered as a result of malnutrition and purging, which could lead to reduced fertility, increased miscarriage, and premature/underweight births. Other biochemical abnormalities from inadequate nutrient intake and purging can affect energy levels and overall physical functioning (e.g., headaches, general muscle weakness) and psychological functioning (e.g., lower well-being, elevated depression).

Individuals who chronically engage in ED behaviors are at a higher risk for these deleterious health conditions. Yet, many others participate in ED behaviors less frequently, but may still be at a significant [Page 580]risk for these conditions. Periodic malnutrition (i.e., from fasting, skipping meals), electrolyte disturbances, and weight cycling are common among those who meet some, but not all, of the criteria for clinical eating disorders. This finding highlights the importance of attending to all individuals who display ED symptoms and not solely focusing on those who meet the threshold for a clinical ED diagnosis.

The Spectrum of Eating Behavior

Eating behavior may be conceptualized along a continuum, with one pole representing clinical EDs and the opposite pole reflecting adaptive eating. The intermediate range is characterized by the use of harmful weight control strategies and food preoccupation, but at a less severe level than that of a diagnosable ED. However, because individuals in the intermediate range may jeopardize their physical and psychological health via maladaptive weight control techniques, it is crucial for counselors to focus on preventing and treating all degrees of ED symptomatology.

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