Medical complications of anorexia nervosa
An assessment of the patient’s symptoms and the severity of their disorder determines the setting (medical or psychiatric admission, or outpatient treatment) for medical stabilisation. Complications of anorexia nervosa may include:
- acute pancreatitis
- amenorrhoea
- brittle hair, hair loss, lanugo hair
- constipation, reduced gastric motility (and early satiety)
- dorsal hand abrasions
- dental erosions
- facial purpura, conjunctival haemorrhage
- hypokalaemia—common complication of purging behaviour and laxative abuse, and can lead to cardiac dysrhythmia
- iron deficiency
- Mallory-Weiss tears, ruptures
- oesophagitis
- osteopenia, stress fractures—the efficacy of hormone replacement therapy and bisphosphonates for the management of osteopenia in people with anorexia nervosa is unclear, seek specialist advice. Vitamin D and calcium supplementation is insufficient alone; additional supplements are required
- poor metabolic control in coexistent Type 1 diabetes
- parotid and salivary gland hypertrophy
- secondary hyperaldosteronism.
If a complication of anorexia nervosa is secondary to malnutrition (eg fluid and electrolyte changes, pancreatitis), treatment should also include nutritional replenishment. If complications are caused by purging or other behaviours (eg Mallory-Weiss tears, parotid and salivary gland hypertrophy, conjunctival haemorrhage), these behaviours should be addressed with psychological treatment.