If anorexia nervosa is not treated, it can lead to severe health problems. If treatment is not improving your symptoms, or you start to get worse, your healthcare professional may consider changing your treatment. This may include treatment in hospital if your health is seriously at risk.

It is quite common for anorexia to come back after treatment. For example if someone’s weight starts to fall again, or after having a baby, when a woman tries to lose the weight she gained during pregnancy.

Other health problems

If someone has anorexia for a long time, it can lead to severe complications and health problems. Sometimes, these problems can be permanent. For example, if your bones become damaged.

People with anorexia have an increased risk of:

1. poor circulation and cardiovascular problems, and
2. heart conditions, such as coronary heart disease and irregular heartbeat (arrhythmia).

Sometimes, anorexia can lead on to developing another eating disorder, bulimia nervosa.

Anorexia can cause the balance of minerals in the blood to become abnormal, such as potassium, calcium and sodium. This is known as electrolyte imbalance. These minerals play an important part in keeping you healthy. For example, a low level of potassium (hypokalaemia) is a common complication that can cause:

1. tiredness,
2. weakness,
3. dehydration,
4. kidney damage,
5. fits (seizures or convulsions), and
6. irregular heartbeat (arrhythmia).

Low levels of calcium can cause muscles to contract tightly and painfully (spasms). This is called tetany. Lack of calcium and vitamin D can cause bone damage.

Lack of sodium (hyponatraemia) can cause people to become confused. In severe cases it can also cause fits (seizures or convulsions). A fit is when your body shakes uncontrollably, and is caused by your muscles contracting.

Other complications of anorexia can include:

1. low blood pressure (hypotension),
2. anaemia,
3. dental problems, caused by regular vomiting when stomach acid affects the enamel on the teeth,
4. low blood sugar levels (hypoglycaemia),
5. acute kidney (renal) failure,
6. liver damage,
7. heart failure,
8. osteoporosis (fragile bones) and loss of muscle strength, particularly in women and girls, and
9. loss of sex drive (libido) and impotency in men.

Misuse of laxatives can permanently damage the bowels and cause permanent constipation.

Anorexia and pregnancy

If you have anorexia and you are pregnant, your doctor or midwife will monitor your health closely during your pregnancy and after your baby is born. You may need extra health checks as part of your antenatal and postnatal care. Anorexia during pregnancy can increase the risk of complications, such as

1. miscarriage,
2. giving birth early (premature birth),
3. a low birth weight baby, and
4. Caesarean section.

You are also likely to need extra care and support during pregnancy, if you have previously had anorexia and recovered from it.

Anorexia and other health conditions

If you have anorexia and another health condition, you will need to take extra care of your health. For example:

• If you have diabetes, you will need regular health checks, to help avoid problems with your eyes or other serious complications. This is particularly important if you have type 1 diabetes,
• If you have a bone condition, such as osteoporosis, your doctor will probably advise you to avoid any physical activities that may lead to falls.

Recovering from anorexia

People with anorexia nervosa can recover. However, it may take a long time. It can also be very difficult, both for the person affected and their family and friends.

The first step towards getting better is to recognise the problem and to have a genuine desire to get well. This may involve a big change in lifestyle and circumstances. Sufferers need to explore and understand the underlying issues and feelings that contribute to the eating disorder, alongside changing their attitudes to food and weight.

To recover, someone with anorexia needs to:

1. gain weight safely,
2. change their eating habits, and
3. change the way they think about food.

The longer someone has had anorexia, the harder it is to re-learn healthy eating habits and gain weight. It is important therefore to start treatment as early as possible, so the person has the best chance of recovery.

For most people, recovery goes through several stages, where progress may be marked by steps forward and steps back.

Research studies have shown that:

1. about 43% of people with anorexia recover completely,
2. 36% improve,
3. 20% develop a chronic eating disorder, and
4. 5% die from the condition.

Related articles

1. Anor­exia nervosa
2. Causes of, and dia­gnos­ing anor­exia (eat­ing dis­order)
3. Eat­ing dis­orders: not eat­ing or eat­ing too much
4. The Symp­toms of Loss of Appet­ite (Anor­exia) 
5. The med­ical and psy­cho­lo­gical treat­ment for anor­exia 
6. Heart dis­ease a killer in psychotic indi­vidu­als

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