Can Eating Disorders be cured?

Anorexia Nervosa. It is a serious disorder associated with a higher mortality risk than other psychiatric disorders. The mortality, in the majority of cases, is due to direct causes of the malnutrition. It is estimated that around 5% of patients die due to complications of the illness and that 1 in every 5 patients die of suicide. Long term studies show that between 50% and 85% of those with Anorexia Nervosa fully recover. The prognosis is better in cases of Anorexia Nervosa that start in adolescence rather than in adulthood. In a significant percentage of cases, the symptoms can change over time. According to one study, almost half of those with Anorexia Nervosa could end up developing bulimia symptoms. An individual may recover from one ED and later relapse into a different disorder.

Bulimia Nervosa. The mortality risk is not as elevated as in Anorexia Nervosa, but the percentage of patients that die due to suicide is higher. Long term studies (20 years) show that 75% fully recover.

Binge eating disorder. Long-term follow-up studies into Binge Eating Disorders are limited, but studies at 2 and 4 years have found recovery rates that vary between 52% and 76.7%. There are no data on the mortality associated with this disorder.

Avoidant/Restrictive Food Intake Disorder. On being a new disorder, there are few studies. One study did not observe any differences with Anorexia Nervosa as regards the prognosis at one year, but another recent study did observe a better prognosis in the disorder compared with Anorexia Nervosa.

Cardiovascular. The most frequent are the appearance of a low heart rate and hypotension. Other less common cardiovascular changes can be associated with changes in cardiac rhythm and sudden death. The presence of dizzy spells and fainting should alert to a possible serious complication. The compensatory behaviours such as vomiting and the taking of laxatives can be associated with a lowered potassium that could lead to a change in cardiac rhythm and sudden death. Other electrolytes, like chloride and sodium, can be affected by compensatory behaviour or the excessive ingestion of water.

Endocrinological. It includes the absence of menstruation, infertility, osteoporosis, detention of growth and intolerance to cold. The osteoporosis may not be reversible with recovery. Changes in thyroid hormones may be detected in the laboratory tests, as well as an increased blood cholesterol and a decrease in glucose in the most severe cases. Binge Disorder has been associated with overweight and obesity, which could involve an increase in the risk of metabolic syndrome.

Gastrointestinal. Constipation and delayed gastric emptying are very common. The delay in gastric emptying is associated with abdominal pain, a bloated sensation and early feeling of being full after ingestion, including very small amounts of food. Other rare, but more serious, gastrointestinal changes, include gastric swelling that presents with nausea and vomiting and intense abdominal pain or pancreatitis. Binge eating can be complicated with a rupture of the stomach, and the self‑induced vomiting can cause a rupture of the oesophagus, both very serious complications. The vomiting can also affect the teeth and inflame the salivary glands.

Neuropsychiatric. They can present as problems in concentrating, irritability, changes in mood, depressive symptomatology, and/or obsessive symptoms. In some cases, there can be self-injury or suicide ideation.

Haematological. The malnutrition can be associated with the appearance of anaemia, a decrease in the white cells responsible for immunity, and a reduction in platelets.

Dermatological. Hair loss is more common in malnutrition. In severe cases of malnutrition fine hair may appear all over the body, or acne, among others.

Psychosocial. EDs can have a significant negative impact on the quality of life of those that have it, as well as those in their nearest environment, generally the families that live with them. The self‑image, the relationships, and academic or work performance are often harmed. It is often very difficult to say whether these problems are secondary to the Eating Disorder or they have contributed to its development; but in general, all these factors often interact and become worse with the progression of the disorder.