Eating disorder natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Most of the medical complications in eating disorders are due to weight changes, malnutrition or induced vomiting. Induced vomiting can put a patient at risk of developing life threatening electrolyte abnormalities consequently leading to cardiac arrhythmias. In addition, dermatological complications such as dry skin, brittle nails and pruritus are common due to malnutrition. Furthermore, chronic constipation can lead to rectal prolapse and bleeding per rectum. Nonetheless, it is important to consider various systems in patients with eating disorders because of high mortality rates specially in patients with anorexia nervosa.

Natural History, Complications, and Prognosis

Natural History

• The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___.
• The symptoms of (disease name) typically develop ___ years after exposure to ___.
• If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].

Complications

• Common complications of Anorexia Nervosa include:
  • CARDIOVASCULAR
• bradycardia
• hypotension
• mitral valve prolapse
• peripheral edema
• refeeding syndrome
  • DERMATOLOGICAL
• dry skin
• Lanugo hair
• pruritus
  • GASTROINTESTINAL
• constipation
• refeeding pancreatitis
• acute gastric dilatation due to refeeding
  • ENDOCRINE AND METABOLIC
• amenorrhea
• infertility
• osteoporosis
• hypoglycemia
• hypercortisolemia
• thyroid abnormalities
• impaired temperature regulation
• fluid and electrolyte abnormalities
  • HEMATOLOGICAL
• pancytopenia

• Common complications of Bulimia Nervosa include:
  • Gastrointestinal
• dental erosion
• parotid gland swelling
• esophageal rupture
• post binge pancreatitis
• constipation
• cathartic colon
  • PULMONARY/MEDIASTINAL
• [[Aspiration pneumonitis
• pneumothorax]] or rib fractures
• pneumomediastinum with weight loss
  • CARDIAC
• mitral valve prolapse
• palpitations
• hypertension
• arrhythmias
  • ENDOCRINE
• hypoglycemia
• mineralocorticoid excess
  • METABOLIC
• dehydration
• nephropathy
• electrolyte imbalances

Prognosis

• Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [--]%.
• Depending on the extent of the [tumor/disease progression] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
• The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
• [Subtype of disease/malignancy] is associated with the most favorable prognosis.
• The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.