As an eating disorder specialist and therapist, I’ve worked with many individuals who believed they “weren’t sick enough” to deserve help. Many of these beliefs come from common cultural misconceptions about what someone with an eating disorder “looks like”.
People often believe that for someone to have an eating disorder, they must have rapid and extreme weight loss resulting in a visibly underweight body type. This is wildly inaccurate. While it can happen this way, the vast majority of people with severe eating disorders are in bodies of all shapes and sizes. Many have not experienced a significant shift in weight because their bodies have adapted to the change in food patterns.
Let’s break down how eating disorders affect different systems in the body, and why it’s never too late to seek eating disorder treatment and start the healing process.
The Heart: A Silent Victim
One of the most concerning impacts of eating disorders is on the cardiovascular system. Malnutrition, whether from restriction, purging, binge eating, or binge-purge cycles, can cause heart irregularities, including atrophy. This means the heart muscle literally shrinks. It becomes weaker and more vulnerable to arrhythmias (irregular heartbeats) and even sudden cardiac arrest.
Bradycardia (a dangerously slow heart rate) is a common finding in those with anorexia nervosa. It’s often seen as a sign of “fitness” by the individual. In reality, it’s a protective mechanism of the body conserving energy in the face of starvation. In Sick Enough, Dr. Gaudiani describes how even mild to moderate restriction can cause heart complications. Even in those who do not appear medically underweight.
But here’s the good news: the heart is remarkably resilient. With nutritional rehabilitation and sustained treatment, heart function can improve dramatically.
The Gastrointestinal System: Slowed and Suffering
Many people with eating disorders experience chronic constipation, bloating, early fullness, and abdominal pain. These symptoms are not “in your head.” They’re the result of slowed gastrointestinal motility due to malnutrition. The stomach empties more slowly, the intestines become sluggish, and digestive enzymes decrease.
Laxative abuse, often present in bulimia nervosa, can cause long-term damage to the colon and electrolyte imbalances. Purging through vomiting not only damages the esophagus but also disrupts the normal acid-base balance in the body. Sometimes dangerously so.
Dr. Gaudiani emphasizes that gastrointestinal distress is often a key driver of continued eating disorder behaviors. Patients restrict or purge to avoid painful bloating or discomfort. Treatment that addresses both refeeding and symptom management is essential for healing the gut and breaking the cycle.
Hormonal Chaos: Disruption Across the Board
One of the body’s first responses to starvation is shutting down non-essential systems to conserve energy. This includes the reproductive system. Many people with eating disorders experience amenorrhea (loss of periods),
The absence of menstruation is not just about fertility. It signals that the body is in survival mode. Low estrogen levels also contribute to early-onset osteoporosis. Dr. Gaudiani’s work underscores that you don’t need to be underweight to experience hormonal dysregulation. Even in larger bodies, chronic restriction can disrupt hormones like cortisol, thyroid hormone, and sex hormones.
With adequate nutrition and consistent treatment, hormonal health can return. However, the longer the restriction continues, the more difficult it becomes to restore. That’s why it’s essential to seek and maintain eating disorder recovery.
Bone Health: Damage That Starts Young
Bone loss is one of the more insidious consequences of eating disorders. It often occurs silently and becomes irreversible if not caught early. Peak bone mass is typically achieved in the late teens to early twenties. This window is often compromised in individuals with eating disorders.
As Dr. Gaudiani outlines, restrictive eating, amenorrhea, and low body weight are a dangerous combination for bone density. Unfortunately, lost bone mass is difficult to regain, even after recovery. This makes early intervention especially critical in young patients.
But even in later years, stopping bone loss and improving stability is possible. Eating disorder recovery includes nutritional rehabilitation, weight restoration, and sometimes medication. It’s not too late to care for your bones.
The Brain: Cognition, Mood, and Identity
Perhaps one of the most misunderstood effects of eating disorders is their impact on the brain. Starvation alters brain function. Individuals often become obsessive, anxious, and depressed. They may experience brain fog, poor concentration, and a distorted sense of self.
Dr. Gaudiani describes the “eating disorder voice” as a neurobiological phenomenon. It gets louder the longer the brain is malnourished. Thoughts become rigid, fear-based, and compulsive. It’s not weakness or vanity—it’s biology.
The beautiful part? The brain, like the heart, is incredibly neuroplastic. With adequate food, compassionate support, and therapy, people can reconnect to their true selves. Their cognitive flexibility returns, emotions stabilize, and joy becomes accessible again.
You Don’t Have to “Hit Rock Bottom” to Deserve Help
A pervasive myth in eating disorder culture is that unless you're severely underweight or hospitalized, you're not "sick enough" to seek treatment. But the reality is: if your relationship with food is interfering with your life, your joy, your health, or your identity, you are sick enough.
Eating disorders are the second-deadliest psychiatric illness after opioid use disorder. They do not discriminate by weight, age, gender, or race. And they are treatable.
Hope for Healing: Thoughts From an Eating Disorder Therapist
Recovery is not easy. It often means confronting fear foods, gaining weight, resting more, and grieving the identity the eating disorder gave you. But it is possible—and it’s absolutely worth it.
Your body is more resilient than you think. Your brain can rewire. Your heart can heal. Your gut can recover. And your life can become joyful, free, and full again.
Start Eating Disorder Treatment in Utah
Whether you’re just beginning to question your relationship with food or you’ve been struggling for years, it’s not too late. You are not beyond help. And you are absolutely deserving of care through comprehensive eating disorder treatment.
If you’re ready to take the first step, know that there is a team of eating disorder professionals—physicians, therapists, dietitians—ready to walk with you. Recovery isn’t just about food. It’s about reclaiming your life. Here’s how you can get started:
Book a free consultation or contact us at 801-699-6161
Meet with a caring and experienced eating disorder therapist
Start supporting your mental and physical health with Inside Wellness!
Other Services Inside Wellness Offers in Provo and Salt Lake City, UT
Eating disorder treatment is not the only service offered by Inside Wellness. We are happy to provide a variety of other mental health services, including anxiety counseling, body image therapy, and online therapy in Utah. Discover the support and benefits that in-person or online therapy can offer by visiting our blog or FAQ today.