With Healthy Heart Month in full swing, you might be hearing advice everywhere from your family doctor to your favorite newsletter about what to cut out of your diet to keep your heart strong. Ditch the soda! Cut the carbs! Skip the butter! Oh, wait, butter's back in! But maybe olive oil is better?!
While most of us can take this influx of diet advice in stride, those at risk for eating disorders are vulnerable to this deluge of information. In many cases, the eating patterns that eventually precipitated a full-blown eating disorder started with the intention to be healthier and feel better—both physically and emotionally. In a sadly ironic twist, those behaviors have likely contributed to the serious decline in health often associated with eating disorders.
Eating disorders are more than just a psychiatric illness.
In fact, eating disorders have the highest mortality rate of any psychiatric illness (or behavioral health disorder). So not only do they lead to a host of social, mental, and physical problems, but they actually put someone at increased risk for other health problems. Cardiovascular complications are one of the biggest risks for those struggling with eating disorders. The heart is made of muscle and basically functions as a pump that moves blood first to the lungs to pick up oxygen and then out to the extremities to bring oxygen and nutrients throughout the whole body. Our hearts are clearly key to our ability to live and function normally, and eating disorders put strain on the heart in a number of ways.
1. Weaker heart muscles
First, when one does not take in enough food to support our level of activity, the heart rate slows down as the body tries to conserve energy. Also, blood pressure will drop due to dehydration or because the muscles of the heart weaken. When blood pressure is low, it's harder for other organs—like the kidneys, the brain, or the liver—to receive the nutrients and oxygen that the heart usually pumps in their direction.
People with low-weight eating disorders actually lose cardiac muscle mass. All muscles of the body are subject to wasting away if we aren't nourishing them. Heart muscle is no exception. Underweight patients may develop mitral valve prolapse due to shrunken heart muscle cells, or they can develop heart failure due to a weakened heart that can't pump well.
2. Shifts in the heart's chemical environment
A second concern is the development of abnormal heart rhythms, which happens frequently when someone is suffering from bulimia nervosa. The behaviors of binge eating and purging (which can involve not just vomiting but also laxative and diuretic use), can lead to dehydration and dangerous shifts in electrolytes in the body. When the chemical environment of the heart is abnormal, the heart is at risk for arrhythmias, which can cause heart palpitations, fainting, and even death.
3. Cardiac disturbances
And thirdly, there are a host of cardiac rhythm disturbances that are directly caused by weight loss and malnutrition. These are undoubtedly causal in the heightened risk for sudden death seen in people with anorexia nervosa.
Despite these very serious cardiac concerns, many people with eating disorders are reluctant to get help. The disorders themselves are marked by a brain-based type of denial that can make even seeing that there's a problem very difficult. As a clinician, I find that sometimes the presence of these heart issues can help someone see just how high the risk to their health really is.
Healing your body from an eating disorder
But even those who begin the process of recovery have to be very cautious about their heart health. For someone who has been eating very little, starting to eat more can cause its own dangerous shifts in electrolytes called refeeding syndrome, which again puts the person at risk for cardiac complications. Thus, some patients will need to be very closely monitored by a medical team during this process.
The heartening news is that most of physical complications of eating disorders are reversible with good nutrition. Once the body and mind are recovered and a knowledgeable support team is in place, the person has a great chance of living a long, healthy life.
If you've suffered from an eating disorder, keep the following in mind:
- Take any cardiac event very seriously. If you experience any chest pain, are getting dizzy when you stand, have a fainting episode, or notice your heart rhythm seems off, get to a medical provider as soon as you can.
- Enlist the support of others. We know that eating disorders thrive in isolation, and recovery thrives in community with others you care about. Let someone close to you know that you're worried about your health.
- Know that recovery is always possible. Even people who lived with an eating disorder for a very long time can expect a full and lasting recovery. It's not easy and can't be accomplished alone, but EVERYONE suffering from an eating disorder can be helped.
The recently deceased George Michael once said, "You'll never find peace of mind until you listen to your heart." Listen carefully to the messages your heart is sending you. And with the right treatment, you can find peace from the burden of eating disorders.