Eating disorders involve an unhealthy focus on weight and shape, which disrupts normal eating habits.

We’ll discuss the dangers of eating disorders to the heart, warning signs, and the importance of seeking comprehensive treatment.

Overview of eating disorders

Symptoms of eating disorders include abnormal eating behaviors and a preoccupation with body weight, shape, or food. Eating disorders can have severe effects on physical health as well, particularly on the heart, despite usually being associated with mental health issues.

The three most common types of eating disorders are listed below.

Anorexia Nervosa

This disorder is characterized by extreme food restriction, a distorted body image, and an intense fear of gaining weight. When anorexics are dangerously underweight, they often perceive themselves as overweight. There is no mental health condition that has a higher mortality rate than this one.

Bulimia Nervosa

Symptoms include binge eating followed by compensatory behaviors such as vomiting, excessive exercise, or laxative use. A person with bulimia often maintains a normal weight, making it hard to diagnose the condition.

Binge Eating Disorder

It is characterized by eating large quantities of food in a short period of time, often to the point of discomfort. The lack of compensatory behaviors leads to obesity more often than bulimia.

Millions of people worldwide suffer from eating disorders, and it is estimated that 9% of the population will suffer from one at some point. It is most common in adolescents and young adults, but can occur at any age, across all genders, and across all ethnicities. To recognize and treat these conditions effectively, we need to understand their severe health impacts.

How Eating Disorders Affect the Cardiovascular System

An eating disorder can affect the circulatory system and the heart in several ways. Listed below are some basic things you can expect.

Electrolyte Imbalances

When eating disorders involve vomiting, laxative abuse, or extreme dieting, electrolyte imbalance can occur. Heart rhythms and other bodily functions are regulated by electrolytes such as potassium, sodium, calcium, and magnesium. The body cannot maintain normal heart function when these minerals are depleted.

Key effects of behaviors on electrolyte levels

• Potassium and sodium are depleted due to vomiting, which results from the loss of stomach acids.
• Abuse of laxatives results in excessive fluid and electrolyte loss.
• Diets with insufficient nutrients disrupt electrolyte balance.

There can be serious consequences of electrolyte imbalances on heart function, including bradycardia, tachycardia, and weakened heart muscles. 

Any person with an eating disorder, especially one who displays heart symptoms like these, should receive medical monitoring and intervention.

Bradycardia and Tachycardia

The body slows down various bodily functions to conserve energy when it isn’t given the nutrients and calories it needs. 

When the heart beats less than 60 beats per minute, it is called bradycardia. While this can sometimes happen in healthy individuals, particularly athletes, it must be addressed. It’s a sign that the heart is not pumping enough blood to meet the body’s requirements when malnutrition is present.

In the opposite spectrum is tachycardia, in which the heart beats over 100 beats per minute. You are compensating for a lower blood volume and lower blood pressure caused by malnutrition. When the heart rate is consistently high, it exerts excessive strain on the organ, increasing the risk of serious complications such as heart failure or sudden cardiac arrest.

Insufficient blood flow can result in fainting, heart failure, or even death in patients suffering from bradycardia.

Cardiovascular complications such as heart failure and sudden cardiac arrest can occur if you suffer from tachycardia.

A person with either of these problems needs to be screened for malnutrition and heart disease.

Low Blood Pressure (Hypotension)

People with eating disorders are prone to hypotension, or low blood pressure, especially those who suffer from severe malnutrition. As a result of lack of nutrients and energy, blood pressure drops, making it more difficult for blood to circulate.

Causes

• Low calorie intake and dehydration
• A lack of electrolytes weakens the heart’s function
• Lack of fluid intake results in reduced blood volume

Symptoms

• Lightheadedness and dizziness, especially when standing
• Brain blood flow is insufficient, causing fainting (syncope)
• Lack of circulation leads to fatigue and weakness

Long-term Effects on Heart Health

• Strain on the heart  causes the heart to work harder and weaken over time.
• Low blood pressure can cause damage to vital organs by reducing blood flow
• A higher risk of heart failure may occur if chronic hypotension goes untreated.

People with eating disorders often suffer from chronic low blood pressure, which can cause long-term damage to the heart and other vital organs.

Heart Muscle Weakness and Atrophy

The heart muscle can be severely affected by prolonged malnutrition, which is common in people with eating disorders. Muscles, including the heart muscle, are broken down by the body when it lacks essential nutrients and calories. The result is weak heart muscles and atrophy (muscle loss), which seriously impairs the heart’s ability to pump blood.

There is an immediate need to take medical action to prevent heart failure and other severe complications caused by heart muscle weakness and atrophy caused by malnutrition.

Sudden Cardiac Arrest

A sudden cardiac arrest occurs when the heart ceases to beat suddenly, preventing blood from reaching the brain and other vital organs. A combination of severe malnutrition, electrolyte imbalances, and weakened heart muscles increases the risk of SCA in individuals with eating disorders.

Why Individuals with Eating Disorders Are at Higher Risk

• Heart arrhythmias and sudden failure are more likely to occur when the heart is malnourished.
• In SCA, electrolyte imbalances are caused by frequent vomiting, laxative use, and extreme diets.
• A variety of factors can contribute to sudden cardiac arrest, including poor nutrition, weakened heart muscles, and constant stress.

This increases the risk of sudden cardiac arrest for individuals who suffer from eating disorders, highlighting the need for early and aggressive treatment.

Mitral Valve Prolapse and Anorexia Nervosa

In Mitral Valve Prolapse (MVP), the mitral valve, which separates the left atrium and left ventricle, fails to close properly. The improper closure can cause symptoms such as palpitations, chest pain, and fatigue by allowing blood to leak backward into the atrium. 

In spite of the fact that MVP occurs in the general population, it is a common affliction among those suffering from anorexia nervosa. In the case of heart valve dysfunction, the connection lies in the weakness of connective tissue and muscle caused by prolonged malnutrition.

Regular echocardiograms are needed to assess the function and stability of the MVP valve. The treatment may involve lifestyle changes and, if necessary, medications. 

Prevention of further deterioration of heart health is dependent on addressing the underlying eating disorder. It is still possible for heart complications to worsen if anorexia nervosa is not treated.

Warning Signs and Symptoms of Heart Problems in Eating Disorder Patients

Heart problems are common with people who have eating disorders. There are early warning signs that can prevent life-threatening complications. Here are some symptoms to watch out for:

Symptoms That Indicate Heart Problems

• Dizziness or fainting
• Having an irregular heartbeat 
• A feeling of shortness of breath
• Feeling discomfort or pain in the chest
• Cold hands and feet
• Weakness or fatigue
• Swelling

When to Seek Medical Help

People with eating disorders should have regular check-ups to monitor their heart health. Taking action early can prevent heart-related complications from progressing.

If you experience severe chest pain, shortness of breath, fainting, or rapid or irregular heartbeats, seek immediate medical attention.

If you are experiencing persistent symptoms like dizziness, palpitations, or swelling, consult a healthcare provider immediately.

Heart conditions pose a serious or fatal risk to people with eating disorders, so they should be aware of these warning signs.

Prevention and Management

Medical Intervention

Eating disorders can result in serious heart complications if they are not diagnosed and treated early. The treatments for heart issues can include medications to stabilize heart rate, electrolyte supplements, or other interventions tailored to the individual.

Nutritional Rehabilitation

Improved heart health begins with proper nutrition. Nutritionally dense diets help the heart function more effectively and regain strength. Electrolyte management is especially important because imbalances can result in dangerous heart rhythms.

Therapeutic Support

Mental and emotional well-being are equally important when recovering from eating disorders. A key component of treating the disorder is psychological support, such as therapy. Often, the most effective way to protect the health of the heart is to combine medical treatment with nutritional guidance and psychological support.

Long-term Prognosis for Patients

Eating disorders can and do cause heart failure unless treated promptly. It is possible to improve with early intervention including nutrition, medical care, and psychological support. 

If the heart has been severely damaged, it may result in chronic conditions that require lifelong management as well as a decrease in lifespan.

Conclusion

It is possible to suffer from a heart arrhythmia, heart failure, and even sudden cardiac arrest if you have an eating disorder. 

Recognizing heart problems early is critical to preventing severe consequences. Medical intervention, proper nutrition, and psychological support can prevent long-term damage.

If you or one of your loved ones are struggling with an eating disorder, Sirona Therapy can help you. Our specialized team of therapists can provide support and guidance on the road to recovery from these difficult conditions. Take the first step by contacting us today.

References

American Heart Association. (2020). Eating disorders and heart health. Retrieved September 1, 2024, from https://www.heart.org/en/news/2020/09/15/eating-disorders-and-heart-health

American Psychiatric Association. (2022). What are eating disorders? Retrieved September 1, 2024, from https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders

Mayo Clinic. (2023). Eating disorders: Symptoms and causes. Retrieved September 1, 2024, from https://www.mayoclinic.org/diseases-conditions/eating-disorders/symptoms-causes/syc-20353603

National Institute of Mental Health. (2023). Eating disorders: Overview. Retrieved September 1, 2024, from https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml

National Eating Disorders Association. (2023). Health consequences of eating disorders. Retrieved September 1, 2024, from https://www.nationaleatingdisorders.org/health-consequences

U.S. Department of Health and Human Services. (2021). Electrolyte imbalances and cardiovascular effects in eating disorders. Retrieved September 1, 2024, from https://www.hhs.gov/ash/oah/resources-and-publications/medication-guides/electrolyte-imbalances-and-cardiovascular-effects-eating-disorders/index.html