APPENDIX 9
Physical Complications of Eating Disorders - Treatment
Most of the complications are best treated by refeeding with a normal balanced diet and
weight gain back to a healthy weight range in anorexia nervosa. It is best if this process is
done gradually. In bulimia nervosa many of the complications can be corrected by cessation
of binge eating, vomiting and misuse of laxatives or water pills.
For patients who are not able to tackle their nutritional problems by conventional eating over
a short period of time then other measures can diminish the harmful effects of complications.
Limiting exercise will reduce strain on the heart.
Abnormalities in body chemistry can be improved with specific supplements such
as potassium, calcium, vitamin D and iron. Also, multivitamin and mineral
supplements can be used (eg Forceval) or food supplements drinks can be given.
These contain a wide range of essential nutrients.
If the patient has low body temperature then special measures should be taken,
especially in the Scottish winter, to keep as warm as possible.
If the patient is at risk of osteoporosis, calcium and vitamin D can be given. If the
periods have stopped for a year or more then hormone replacement therapy eg in
the form of the contraceptive pill can be given. Avoid high impact exercises in
established bone loss.
If you are unable to avoid using laxatives avoid stimulant laxatives.
There are no specific ways of modifying the damaging effects of starvation on the
blood cells, hormone system, kidneys, liver, pancreas, brain, muscle or skin.
They all require improved balanced nutrition and weight gain which reverses
most of the abnormalities.
Dental care: patients should avoid acidic drinks such as fruit juice and carbonated
beverages. Milk, water, tea or squash are better. If acid beverages are taken they
should be taken using a straw. Brush teeth twice daily, preferably with a
desensitizing toothpaste and after vomiting use a bicarbonate or desensitizing
toothpaste. Also chew gum or rinse with milk. Take in an artificial saliva if dry
mouth and avoid medication that induces dry mouth. Visit a dentist regularly.
Patients may be in denial or have difficulty in appreciating the significance of
investigation results – colour coded charts can be a useful aid in communicating
this to patients. – please see link for charts on main Healthcare Professionals
Page.-
MCN Website – Appendix 9