Anorexia Nervosa: Understanding the Risks of Malnutrition and Mortality

Anorexia nervosa (AN) has the highest mortality of any psychiatric disorder. Starvation affects every organ system:

• Cardiac: Arrhythmias (QT prolongation), hypotension, bradycardia, cardiomyopathy, sudden death.
• Electrolyte: Hypokalemia, hyponatremia, hypophosphatemia (refeeding syndrome risk).
• Endocrine: Hypogonadotropic hypogonadism (amenorrhea), bone loss, thyroid suppression.
• GI: Gastroparesis, constipation, hepatic steatosis.
• Neurologic: Brain volume loss, cognitive impairment, seizures.
• Hematologic: Anemia, leukopenia, thrombocytopenia.

Mortality: ~5–10% per decade; suicide and cardiac arrest leading causes. Early intensive treatment (medical stabilization, nutritional rehab, psychotherapy — CBT-E, FBT) improves recovery. Never "watchful waiting" for severe AN.