Eating disorders involve severely disordered behaviors related to nutritional intake and output and have devastating impacts on the body. The body is a miraculous machine that can adapt to changes in environment, lifestyle, and nutrition. Even so, the body is not designed to adapt to malnourishment and many of its systems cannot function without proper nourishment. One of the systems impacted is the endocrine system.

What is the Endocrine System?

The endocrine system is a “complex system of glands and organs” that use “hormones to control and coordinate your body’s metabolism, energy level, reproduction, growth and development, and response to injury, stress, and mood [1].”

Hormones are crucial chemical messengers that communicate to all organs in the body. “When a hormone binds to a receptor, the receptor carries out the hormone’s instructions, either by altering the cell’s existing proteins or turning on genes that will build a new protein. The hormone-receptor complex switches on or switches off specific biological processes in cells, tissues, and organs [2].”

All of the processes mentioned above are crucial to human survival and development, making it incredibly important to ensure optimal functioning of the endocrine system.

What do Eating Disorders do to the Endocrine System?

Eating disorders often impact the endocrine system via a physical response to restriction and malnourishment. This response involves fluctuations in the production and secretion of hormones. The body does this to save energy due to restriction causing the body to be at a deficit.

It is important to note that restrictive eating disorder behaviors are not the only to impact the endocrine system. Disorders such as Bulimia Nervosa, which involves purging behaviors, impact this system as well and can lead to malnourishment and, therefore, many of the impacts are detailed below.

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Hypothalamus

The hypothalamus is located at the base of the brain and “secretes hormones that stimulate or suppress the release of hormones in the pituitary gland, in addition to controlling water balance, sleep, temperature, appetite, and blood pressure [1].”

Eating disorders starve the brain and, therefore, the ability of the hypothalamic region to do its job is impaired.

This is important to eating disorder consequences as well as maintenance. Without the hypothalamus functioning optimally, important cues to improve nourishment such as thirst, hunger, and fullness are altered.

Additionally, individuals’ circadian rhythms are affected, leading to a lack of sleep that impacts the body’s healing as well as an individual’s ability to focus and engage in daily life effectively.

The hypothalamus is particularly important in receiving and recognizing the signals being sent by the hormone leptin which “is thought to be a signal to the brain of nutritional status. It also changes rapidly with food restriction [3].” This impairs food intake and energy restriction.

The hypothalamus also receives and implements signals from the luteinizing hormone (LH), which is crucial to female and male reproductive system functioning. LH is made in the pituitary gland and then goes to the hypothalamus. In receiving LH, the hypothalamus sends important signals to the body that control the production of estrogen, the rhythm of the menstrual cycle, and/or trigger the release of an egg in women [4]. In men, LH is crucial to testosterone production. Without the signals of LH being interpreted and implemented effectively, one of the most widely understood endocrine complications due to malnourishment can occur: hypothalamic amenorrhea. This involves the menstrual cycle stopping for prolonged periods of time due to impairment in the hypothalamus and can impact an individual’s fertility and reproductive health long-term.

Ovaries

As mentioned above, malnourishment has a severe impact on the menstrual cycle and the hormones involved in effective ovarian functioning.

It isn’t only restrictive behaviors that can impact ovarian functioning, however, as binge eating behaviors have been found to be associated with Polycystic Ovarian Syndrome (PCOS) [4]. One study notes that, while the link between these has been difficult to pin down, the relationship between the two is “unsurprising, given the overlap in symptoms such as difficulty losing weight, irregular menstrual cycles, infertility, and hirsutism [5].”

This relationship also occurs conversely, as PCOS symptoms are shown to increase binge eating and bulimia behaviors. PCOS involves an overproduction of the hormone testosterone, resulting in hyperandrogenism, or, high androgen levels [5]. High androgen levels can stimulate appetite and this can lead to difficulty with impulse control related to food [5].

Adrenal Gland

Adrenal glands are located on top of both of the kidneys and produce hormones that help to regulate metabolism, immune system, blood pressure, and response to stress.

Eating disorder behaviors can result in either overproduction or underproduction of the hormones related to these processes, impacting serious body functions that are required for survival.

Disorders that can result if eating disorder behaviors are left untreated include Adrenal Fatigue Syndrome (AFS), Addison’s Disease, Cushing’s Syndrome, and Adrenal Gland Cancer, to name a few.

Swollen Glands

Swollen glands will impact between 10 and 50% of individuals with anorexia nervosa binge-purge type and bulimia nervosa [6].

Research indicates the relationship between eating disorders and spleen salivary glands is related to “nutritional deficiency, use of appetite suppressants, unusually low body mass index, starvation, hormonal irregularities, and purging behaviors (e.g., self-induced vomiting) [6].”

The parotid gland is a salivary gland that is particularly impacted by purging behaviors, as these glands will overproduce saliva to protect the esophagus and the mouth from the acidity of the vomit.

How to Recover from an Eating Disorder

In all of the above discussions of body functions, it is clear that the body simply cannot sustain the damage caused by eating disorder behaviors.

There is hope, however. The body is an incredible machine that is capable of healing itself. The key to it doing so is allowing proper nourishment and proper rest to support the healing process.

If you or a loved one are struggling with an eating disorder, there is good reason to be concerned about how these behaviors are impacting the body.

Seek help by first reaching out to your therapist or primary care doctor, as they can support you in learning about your current body processes and functioning as well as explore what is needed for you to find appropriate eating disorder treatment.

Your body is capable of healing itself, however, it cannot do so without your effort as well.

Resources

[1] Unknown (2021). Anatomy of the endocrine system. Johns Hopkins University, Retrieved from https://www.hopkinsmedicine.org/health/wellness-and-prevention/anatomy-of-the-endocrine-system.

[2] Unknown (2021). What is the endocrine system? United States Environmental Protection Agency, Retrieved from https://www.epa.gov/endocrine-disruption/what-endocrine-system.

[3] Warren, M. P. (2011). Endocrine manifestations of eating disorders. The Journal of Clinical Endocrinology & Metabolism, 96:2.

[4] Miller, K. K. (2013). Endocrine effects of anorexia. Endocrinology & Metabolism Clinics of North America, 42:3.

[5] Krug, I., Giles, S., Paganini, C. (2019). Binge eating in patients with polycystic ovarian syndrome: prevalence, causes, and management strategies. Neuropsychiatric Disease and Treatment, 15.

[6] Colella, G., Lo Giudice, G., De Luca, R. et al (2021). Interventional sialendoscopy in parotidomegaly related to eating disorders. Journal of Eating Disorders, 9:25.

Author: Margot Rittenhouse, MS, LPC, NCC

Page Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC / 12.10.21

The Effects of Eating Disorders on the Endocrine System