Medical complications of anorexia nervosa

Abstract

Anorexia nervosa is a serious systemic disease affecting virtually all major organ systems. It is frequently undiagnosed, or there is a significant delay in the diagnosis. Anorexia nervosa is one of the few major medical diseases where patients frequently do not seek help and may actively hide their symptoms, making it especially hard for physicians to diagnose and treat. Anorexia has many endocrine and reproductive complications, including amennorhea or irregular menses, delayed puberty, changes in ovarian morphology, and infertility. Women with anorexia have worse pregnancy outcomes; pregnancy itself may also worsen their symptoms of anorexia. Anorexia nervosa is a disease with high morbidity and mortality; patients may die, especially from cardiovascular complications. Anorexia also can cause gastrointestinal, renal, biochemical, hematologic, dermatologic, and metabolic complications. Comorbid psychiatric illnesses occur in greater than 50% of patients with anorexia. Ob/Gyn physicians must know how to adequately assess patients for the presence of anorexia and understand basic treatment principles.