Eating Disorders: What's Happening on the Inside?

“Do I want to die from the inside out or the outside in?”

― Laurie Halse Anderson, Wintergirls

The human body is amazing and will go to great lengths to protect itself, and that is exactly why eating disorders are so devastating….

         Whenever a person “diets", drastically reduces caloric intake or skips meals, the body goes into survival mode.  The body instinctively believes there is a scarcity of food and, therefore, thinks it must conserve energy.  The metabolism (the rate at which the body converts food into energy) slows down so that consumed food will last longer.

         When diets become extreme, as in anorexia, the entire body slows down in an attempt at self-preservation.  The heart rate slows, and since the heart is a muscle, if activity slows down, the muscle begins to atrophy, or grow weaker.  The weakening and slowing of the heart causes a slower blood flow, which results in lower blood pressure.  These factors combine to cause fatigue, weakness and fainting.  Since the body believes there is not enough food to sustain its own activity, it will not allow the possibility of supporting a second life, and, therefore, the reproductive system shuts down.  Female anorexics develop amenorrhea (ceasing of menstrual periods), which can cause difficulty in getting pregnant in the future, and a decrease in estrogen levels.  The body uses estrogen to aid calcium absorption, and reduced calcium absorption leads to reduced bone mass, resulting in osteoporosis.  Restricting food means that the body is not getting all the necessary vitamins and minerals it needs to function.  Reduced calcium intake increases the osteoporosis risk, and decreased iron intake can lead to anemia, which causes fatigue and bruising.  As the anorexic’s weight decreases, his/her layers of fat are also reduced.  Without a sufficient layer of fat to preserve body heat, the body grows lanugo (a down-like covering of hair) over its entirety in an effort to stay warm.

Those suffering from bulimia are constantly bingeing on food and then purging the body of it.  This behavior keeps the body from absorbing necessary nutrients and causes electrolyte and chemical imbalances.  Sodium and chloride regulate fluid levels in the body, and when there is an imbalance in these minerals, dehydration can occur.  Sodium is also responsible for generating electrical impulses.  A sodium imbalance can be responsible for nervous system malfunctions. Potassium is used by the body to regulate heart rate and muscle function.  Too much or too little potassium can lead to arrhythmias (irregular heartbeats), which can cause heart failure.  Unbalanced potassium levels also affect the nervous and muscular systems, resulting in diminished reflexes.  The purging behavior irritates and inflames the esophagus which results in a chronic sore throat and can lead to an esophageal rupture.  The constant abuse weakens the stomach muscles making the stomach susceptible to ulcers.  A weakened stomach operates slowly, and food that is in the stomach remains there for a long time, allowing bacteria to grow and an ulcer to develop.  Since the stomach walls are weakened, there is also the potential for stomach ruptures.  Dental health is also affected, and the teeth become stained and decay from the stomach acids they are exposed to each time a bulimic vomits.  As in anorexia, there is a disturbance in menstrual function, and the reproductive system begins to shut down, putting the female bulimic at risk for future pregnancy complications as well as osteoporosis due to reduced estrogen levels.

         Eating disorders may begin as a small pre-occupation with food, but they soon take on a life of their own.  The psychological part of the disease drives the illness, but the physical destruction is widespread, not always reversible and can be fatal.

         My next post will focus on the role dance educators can play in helping to reduce the risk of eating disorders among their students and the resources that are available for those battling these diseases.

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