When Anita began to eat more, she was troubled by bloating and constipation, which her doctor attributed to a slowdown in the movement of food through her stomach and intestines as a result of malnutrition. “He felt that with continued healthy eating, these discomforts would go away,” says Anita. “My vital signs had improved and were now normal. He told me that if I kept up the good work, I’d be strong enough to participate in a one-day group scuba-diving adventure that I’d found out about. I definitely wanted go on that expedition, but I didn’t want to gain any more weight. In fact, I wouldn’t have minded losing a few pounds.”

Individuals who induce vomiting are subject to inflammation of the lining of the digestive tract and esophagus due to acid that backs up toward the mouth along with stomach contents. As our patient Rose, now 25 and doing well in recovery from anorexia and bulimia, recalls, “My heartburn, my sore throats, and my swollen salivary glands all went away when I cut back on my bingeing and vomiting. My strange taste preferences faded as I gained weight.

My periods had stopped because I was so skinny. About six months after I reached what my treatment team called my ‘goal weight,’ my menstrual cycles started up again. Unfortunately, there was one problem that didn’t go away, and that involved my bones.”

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David B. Herzog, M.D., Debra L. Franko, Ph.D., Pat Cable, RN

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David B. Herzog, M.D., is the Harvard Medical School Endowed Professor of psychiatry in the field of eating disorders at Massachusetts General Hospital and the director of the Harris Center at Massachusetts General Hospital.
Debra L. Franko, Ph.D., is a professor in the Department of Counseling and Applied Educational Psychology at Northeastern University and the associate director of the Harris Center at Massachusetts General Hospital
Pat Cable, RN, is the director of publications at the Harris Center.