THOUGHTS; The neuro-pathways of the eating disordered individual.
SKELETAL SYSTEM; How anorexia impacts bone density and reproduction (both linked through hormones).
The Damage: The skeletal system can be subjected to extensive damage as a result of malnourishment. Mainly, the way the bones are impacted structurally- in the form of osteopenia (pre-osteoporosis) and of course, osteoporosis.
Bones are very hard and strong on the outside and spongy on the inside, making them rigid and strong. Our bones make up our scaffolding and when you consider the fact we have 205 bones in our body, it is easy to understand how a lack of nutrition could impact the strength and health of the bones. In the living person, our bones are quite soft and have many blood vessels lining them which supply nutrition to the bones. Our bones give us structure, our shape, protect our insides, move our body with the help of our muscles and store and release minerals like calcium. Our bones also make red and white blood cells in the bone marrow. People with osteoporosis have bones with large large holes in the once spongy space of the interior. Large holes make the strength of the bones significantly reduced and unstable and therefore are much easier to break.
This means, a simple fall could result in a broken hip, require surgery, cause pain, deform the person and the list goes on. The way I like to explain what happens to the bones is to think a little outside the box and try to imagine a time when you have seen rotten wood or damp wood outdoors. I remember camping as a child, where I was required to pick up little wooden logs or sticks to fuel the campfire and when I came across damp or wet wood, it was so rotten on the inside that it was extremely delicate. Now- with malnourished people I think of the bones as being very delicate like damp wood. It is now easy to visualise how a small trip or fall or sneeze could actually break the bone. It is hard to imagine if you have never broken a bone but the pain is so excruciating.
The Reversal: Sadly, osteoporosis is NOT reversible. When I was inpatient, every patient I met either had osteopenia or osteoporosis. I know several people who have broken bones and found it shocking to hear them talk about it so casually. For those with osteopenia, good news- with proper nutrition and rapid response following learning about your diagnosis, you can reverse osteopenia and prevent osteoporosis. The bones require calcium primarily and it is for this reason that it is essential to consume foods with calcium such as dairy (milk, cheese, yogurt) and spinach.
The female hormone oestrogen is essential for healthy bones. When monthly periods stop in people restricting calories, oestrogen levels fall. This can lead to a rapid decrease in bone density. Having a BMI of 19 or less will put anyone at risk. With osteoporosis, even cough or sneeze could can cause a rib fracture or the partial collapse of one of the bones of the spine.
The Secondary Biological Effects of Eating Disorders
THE DAMAGE - EXPLAINED THROUGH EACH BODY SYSTEM - The neural pathways in the brain, the bones, the immune system, the digestive system, body mass index.
Never underestimate the devastating effects of malnutrition on the body. The physical impact of eating disorders are very real and can occur rapidly. Everyone is different and our genetics play a role in the way our bodies will react to starvation. When the body is starving, and no energy is left in the form of food (glucose molecules) the body will go onto glycogen stores in the liver, a saved form of energy in the form of sugar. When glycogen stores are depleted and there is no energy in the form of macronutrients from food sources: fats (lipids), sugars (glucose), proteins (peptides), the body will begin to ‘eat itself’. While it may be hard to grasp such an abstract, horrible concept, you should not ignore these facts.
If you are a chronic food restrictor or have had lengthy periods of time without food in the past your body has already suffered, even if you think you feel ‘fine’. Everyones body will deteriorate differently in terms of which organs are impacted first and how long it will take. A good way to know whether your body has been impacted is by considering how long you have restricted your calorie intake and how severe the restriction is. You may have been suffering from an eating disorder for less than a year or for a very short period of time and have therefore made the assumption that no damage has been done and nothing will happen. It is normal to deny even considering that the body is being damaged as no one wants to accept the scary reality. Sadly, there is a good reason why anorexia has the highest mortality rate of any other mental illness and it is quite obviously due to the lack of food required to function and survive and thrive in the world.
While some anorexics can live 20 years with the illness, others may pass away after a few months. Some can even have recovered from their illness yet live with irreversible damage to the body and/or die as a result of the damage sustained. The main cause of death in the anorexic is from cardiac complications. Namely, sudden death by cardiac arrest. This is why Recovery Revolution would really like to spread word on the effects; to hopefully prevent the tragic death or onset of organ damage as a result of anorexia. The impact of anorexia on each body system will be explained systematically
in 19__ during the second world war, __X men in their twenties vounteered to take part in a study titled the 'Minnesota Starvation Study' with the aim of providing researchers with in-depth information of the secondary health implications, both psychological and physical, regarding the effects of starvation.
Nerve endings; branching connections in the brain.
Bone density; hormone loss, infertility and vulnerable bones prone to breaking
CARDIOVASCULAR SYSTEM; How eating disorders damage the heart, both structurally and functionally.
The damage: The circulatory is composed of the heart, veins and arteries. When the heart is damaged, the risk of death increases dramatically. A physician sadly explained how and why the heart can break down and ‘eat itself’ when severe starvation occurs. For those who do not know, the heart is a muscular organ which is very tough in texture and the reason the heart can eat itself is the body cannot differentiate between the important and non important muscles when it breaks down. This mean- when fat/and or energy stores are used up the body can break down muscles in the legs first, arms first, or heart. Heart failure, cardiac arrest and arrythmias all contribute to making anorexia the number 1 mental illness in terms of death rates.
As result of my anorexia I developed a chronic low pulse and permanent damage. I now have a heart condition, an arrhythmia named ‘ventricular bigemini’, when the heart prematurely contracts. People with eating disorders are likely to have ECG’s done (electrocardiograms). These visually demonstrate the way the four chambers of the heart contract and reveal whether the ED sufferer has arrhythmia's and damage in general. The ECG’s are read in terms of time; time it takes for the heart to contract and how often it contracts in between each beat.
There is a dangerous condition which may arise as a result of starvation- a reading which nurses look out for as it suggests high risk of cardiac arrest. It is called prolonged QT wave syndrome. Every time your heart beats, it produces tiny electrical signals. An ECG machine traces these signals on paper, where each heartbeat is mapped as five distinct electrical waves – P, Q, R, S and T.
The part of the pattern from Q to T represents the electrical activity of the heart's lower chambers, or ventricles. In people with long QT syndrome, this Q-T interval lasts abnormally long. In other words, it takes longer for the heart cells in the ventricles to recharge after each heartbeat. This can upset the careful timing of the heartbeat and may trigger an abnormally fast heart rhythm.
The devastating impact of restriction on the heart
SKIN, HAIR & TEETH: How anorexia dries and ages the skin, increases hair loss and tooth damage.
Skin hair and teeth; Deterioration of these structures and impact on appearance.
KIDNEYS: The impact of restriction/ anorexia on the kidneys
Lack of food intake; the devastating impact on kidneys
The Kidneys
There is no doubt that anorexia can damage the kidneys severely. The two bean-shaped organs are each about the size of a closed fist and located just below the rib cage, on either side of the spine. Every day, kidneys filter 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. The urine flows to the bladder through two thin tubes of muscle called ureters, one on each side of the bladder. The bladder stores urine. Their muscular bladder walls remain relaxed while the bladder fills with urine. When the bladder is full it gives off signals to the brain to tell a person to find a toilet soon. When the bladder empties, urine flows out of the body through a tube called the urethra, located at the bottom of the bladder. In men the urethra is long, while in women it is short.
Why are the kidneys important?
They maintain the composition of the blood stable, letting the body function and they:
• prevent the buildup of wastes and extra fluid in the body
• keep levels of electrolytes stable, such as sodium, potassium, and phosphate
• make hormones that help
â—¦ regulate blood pressure
â—¦ make red blood cells
â—¦ bones stay strong