Eating disorders, when persistent, can have serious medical consequences. The lifetime mortality from anorexia nervosa is approximately 10%; it is unknown for bulimia nervosa. Table 6-2 lists the common medical complications of eating disorders.

The most serious of these, gastric or esophageal rupture, cardiomyopathy from ipecac toxicity, and cardiac arrhythmias secondary to electrolyte imbalance, can be fatal. Other complications parallel those of chronic medical illness, take a severe toll on the patient’s overall functioning, and cause tremendous suffering and burden for their families. In addition to these medical complications, secondary psychiatric and neurologic sequela include cognitive decline, metabolic encephalopathy, and severe mood disturbance, all with profound consequences for patients and their families.