cont. from

Other Considerations

Anorexia and Pregnancy

Anorexia poses a number of potential problems for the woman who is pregnant or wishes to become pregnant:

• Difficulty getting pregnant/carrying a pregnancy to term because of higher rates of infertility and spontaneous abortion
• Increased risk of low birth weight babies and birth defects
• Malnourishment (particularly calcium deficiency) as the fetus grows
• Increased risk of medical complications
• Increased risk of relapse being triggered from the stress of pregnancy and/or parenthood

Anorexia Prognosis and Complications

Medical complications associated with anorexia include:

• Irregular heartbeat and heart attack
• Anemia, often related to lack of vitamin B12
• Low potassium, calcium, magnesium, and phosphate levels (particularly with binge-purge types)
• Increased cholesterol
• Hormonal changes (can lead to absence of menstrual periods, infertility, bone loss, and stunted growth)
• Osteoporosis
• Seizures and/or numbness in hands and feet
• Disorganized thinking
• Death (suicide is responsible for 50% of fatalities associated with anorexia)

The outlook for individuals with anorexia is variable, with recovery taking between 4 and 7 years. There is also a high chance of disease recurrence even after recovery. Long-term studies show that 50% to 70% of people recover from anorexia nervosa; however, 25% do not fully recover. Many, even after they are considered "cured," continue to exhibit traits of anorexia such as remaining very thin and striving for perfection.

Supporting Research

Birmingham CL, Goldner EM, Bakan R. Controlled trial of zinc supplementation in anorexia nervosa. Int J Eating Disord. 1994;15:251-255.

Biederman J, Herzog DB, Rivinus TM, et al. Amitriptyline in the treatment of anorexia nervosa: a double-blind, placebo-controlled study. J Clin Psychopharmacol. 1985;5(1):10-16.

Blumenthal M, Goldberg A, Brinkman J, ed. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications and American Botanical Council; 2000.

Crisp AH, Lacey JH, Crutchfield M. Clomipramine and 'drive' in people with anorexia nervosa: an inpatient study. Br J Psychiatry. 1987;150:355-358.

Field T. Massage therapy effects. Am Psychol. 1998;53:1270-1281.

Gordon C, Grace E, Emans SJ, Goodman E, Crawford MH, Leboff MS. Changes in bone turnover markers and menstrual function after short-term oral DHEA in young women with anorexia nervosa. J Bone Miner Res. 1999;14:136-145.

Gross HA, Ebert MH, Faden VB, Goldberg SC, Nee LE, Kaye WH. A double-blind controlled trial of lithium carbonate primary anorexia nervosa. J Clin Psychopharmacol. 1981;1(6);376-381.

Halmi KA, Eckert E, LaDu TJ, Cohen J. Anorexia nervosa. Treatment efficacy of Cyproheptadine and amitriptyline. Arch Gen Psychiatry. 1986;43(2):177-181.

Holman RT, Adams CE, Nelson RA, et al. Patients with anorexia nervosa demonstrate deficiencies of selected essential fatty acids, compensatory changes in nonessential fatty acids and decreased fluidity of plasma lipids. J Nutr 1995;125:901-907.

Humphries L, Vivian B, Stuart M, McClain CJ. Zinc deficiency and eating disorders. J Clin Psychiatry. 1989;50:456-459.

Kennedy SH. Melatonin disturbances in anorexia nervosa and bulimia nervosa. Int J Eating Disord. 1994;16:257-265.

Kleifield EI, Wagner S, Halmi KA. Cognitive-behavioral treatment of anorexia nervosa. Psychiatric Clin N Am. 1996;19:715-737.

McClain CJ, Stuart M, Vivian B, et al. Zinc status before and after zinc supplementation of eating disorder patients. J Am Col Nutr. 1992;11:694-700.

McNulty. Prevalence and contributing factors of eating disorder behaviors in active duty Navy men. Mil Med. 1997;162(11):753-758.

Miller LG, Murray WJ, eds. Herbal Medicinals: A Clinician's Guide. New York, NY: Pharmaceutical Products Press; 1998.

Moyano D, Sierra C, Brandi N, et al. Antioxidant status in anorexia nervosa. Int J Eating Disord. 1999;25:99-103.

Pop-Jordanova N. Psychological characteristics and biofeedback mitigation in preadolescents with eating disorders. Ped Int. 2000;42:76-81.

Rock CL, Vasantharajan S. Vitamin status of eating disorder patients: Relationship to clinical indices and effect of treatment. Int J Eating Disord. 1995;18:257-262.

Safai-Kutti S. Oral zinc supplementation in anorexia nervosa. Acta Psychiatr Scand Suppl. 1990;361(82):14-17.

Shay NF, Manigan HF. Neurobiology of zinc-influenced eating behavior. J Nutr. 2000;130:1493S-1499S.

Vandereycken W, Pierloot R. Pimozide combined with behavior therapy in the short-term treatment of anorexia nervosa. A double-blind placebo-controlled cross-over study. Acta Psychiatr Scand. 1982;66(6):445-450.

Wiseman CV, Harris WA, Halmi KA. Eating disorders. Medical Clin N Am. 1998;82:145-159.

Wolfe BE, Metzger ED, Jimerson DC. Research update on serotonin function in bulimia nervosa and anorexia nervosa. Psychopharmacol Bull. 1997;33:345-354.

Young D. The use of hypnotherapy in the treatment of eating disorders. Contemporary Hypnosis. 1995;12:148-153.

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