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Eating Disorder and Respiratory Complications
Eating disorders can negatively impact someone’s health in big ways. These disorders can wreak havoc on every system in the body . This post will cover the different respiratory problems that are associated with anorexia and bulimia.
What are the Possible Respiratory Complications?
There are several different respiratory complications that can result from eating disorder behaviors. Bulimia and anorexia can cause different symptoms. This is because different disordered behaviors, such as food restriction or purging, can impact the body in different ways.
Bulimia Respiratory Health Risks
Bulimia is an official eating disorder diagnosis that is included in the DSM-5. The DSM-5 is the diagnostic manual that healthcare professionals use. For someone to be diagnosed with bulimia, they must meet the following criteria:
- Recurrent episodes of binge eating. For something to be considered a binge, the following two things must be true:
- Eating in a short amount of time (less than two hours), an amount of food that is significantly larger than what most people would eat in the same amount of time
- Feeling out of control during the binge
- Disordered compensatory behaviors in order to prevent weight gain (i.e vomiting, compulsive exercise, fasting, or weight loss medications)
- Binge eating and compensatory behavior happen at least once a week for three months
- Self-esteem is based primarily on body shape, size, and weight 
Simply put, bulimia is an eating disorder characterized by cycles of binge eating followed by compensatory behavior. A compensatory behavior is anything someone does in order to offset the “consequences” of binging.
Some examples of compensatory behavior include self-induced vomiting, laxative use, or abusive exercise. These behaviors can impact parts of the respiratory system in certain ways.
- Medical Issues from Eating Disorders
- Effects Eating Disorders Have on the Muscles and Bones
- The Harm Eating Disorders Have on The Nervous System
- What Eating Disorders Do to the Circulatory System
- Effects of Eating Disorders on Digestion
- How Disordered Eating Affect Respiration
- Circulation Issues from Disordered Eating
- How Disordered Eating Affects Your Endocrine System
- How EDs Affect Your Hair, Nails and Skin
- What Anorexia and Bulimia Do to the Reproductive System
- Your Immune System and Disordered Eating
Bulimia Effects on Mouth
The mouth is part of the respiratory system. Bulimic behaviors, particularly self-induced vomiting aka purging, can damage someone’s mouth. Here are some of the complications that can result from bulimic behaviors:
- Lesions on the roof of the mouth, cheeks, or back of the throat due to repeated exposure to stomach acid
- Canker sores
- Redness and pain
- Swollen cheeks due to enlarged salivary glands 
Can Bulimia Cause Throat Cancer?
In some instances, yes. Throat cancer can occur as a result of repeated instances of vomiting. The stomach acid can cause erosions to form in the esophagus. This is called Barrett’s Esophagus.
This condition increases the risk that someone will develop esophageal cancer. In fact, 10% of people with this condition are estimated to develop throat cancer . However, bulimic behavior can also lead to a chronic sore throat and can also cause the esophagus to rupture.
Bulimia and Lung Problems
While lung problems are a lesser-known side effect of bulimia, bulimic behaviors can certainly damage the lungs. The main risk to the lungs comes from frequent vomiting. This behavior can cause lung aspiration. This happens when someone inhales foreign materials, like vomit. This can damage lung tissues and cause pneumonia, shock, or respiratory disease .
Anorexia Respiratory Health Risks
Similar to bulimia, anorexia can cause damage to the respiratory system. According to the DSM-5, someone is diagnosed with anorexia when they have these symptoms:
- Restricting the amount of food they eat so significantly that it leads to a significantly low body weight
- Intense fear of gaining weight or becoming fat. This fear does not go away even if they are at a severely low weight
- Lack of insight into the severity of their current low body weight or significant influence of weight on self-esteem 
The key difference between bulimia and anorexia is that people with bulimia may be underweight, but they also may be at higher body weight. People with anorexia restrict their food so severely that they are underweight.
Anorexia Throat Problems
People with anorexia may also vomit in order to avoid gaining weight. While people with bulimia do this after binging, people with anorexia may purge even after eating a very small amount of food.
For this reason, people with anorexia may also develop throat problems that are more commonly seen in individuals with bulimia. However, the malnourishment that is typical in anorexia can lead to other throat problems.
Some research shows that malnourishment can cause dysphagia. Dysphagia is difficulty swallowing . People who anorexia are also at risk of developing dysphagia if they are tube fed, which may be required during inpatient eating disorder treatment.
Anorexia Breathing Problems
People with swallowing issues are more likely to inhale food into their lungs . This can lead to aspiration pneumonia . Anorexia can also cause people to have shortness of breath or rapid breathing .
Respiratory Recovery After an Eating Disorder
There are a few key respiratory problems that can result from eating disorders. Throat problems, such as ulcers, can heal. However, this healing isn’t possible until someone stops purging. Similarly, lung problems like aspiration pneumonia and shortness of breath can also heal.
Resources: National Eating Disorders Association. (n.d). Health Consequences. Retrieved October 18th, 2021 from https://www.nationaleatingdisorders.org/health-consequences  American Psychiatric Association. (2013). Feeding and eating disorders. In Diagnostic and Statistical Manual of Mental Disorders. (5th edition, pp. 329-354). American Psychiatric Publishing.  Sierra Nevada. (n.d). Bulimia Can Have Serious Consequences for Throat Health. Retrieved October 18th, 2021 from https://sierranevadaent.com/blog/bulimia-can-have-serious-consequences-throat-health  Promises Behavioral Health. (2013, July 2). Bulimia Does Long-Term Damage to Body. Retrieved October 18th, 2021 from https://www.promisesbehavioralhealth.com/addiction-recovery-blog/bulimia-does-long-term-damage-to-body/  Mentalhelp.net (n.d). Characteristics of Bulimia Nervosa Continued. Retrieved October 18th, 2021 from https://www.mentalhelp.net/eating-disorders/haracteristics-of-bulimia-nervosa-continued/  Northwestern Medicine. (n.d). Causes and Diagnostics of Aspiration Pneumonia. Retrieved October 18th, 2021 from https://www.nm.org/conditions-and-care-areas/gastroenterology/aspiration-pneumonia/causes-and-diagnoses  Healthgrades (2021). Anorexia Nervosa. Retrieved October 18th, 2021 from https://www.healthgrades.com/right-care/eating-disorders/anorexia-nervosa
Author: Samantha Bothwell, LMFT
Page Last Reviewed and Updated By: Jacquelyn Ekern, MS, LPC / 12.7.21