How Eating Disorders Affect the Digestive System

Written by Ben Mahoney from Center for Discovery 

Eating disorders such as bulimia nervosa, binge eating disorder and anorexia nervosa affect 20 million women and 10 million men in the United States and are the leading cause of mortality of any mental illness. Eating disorders can cause severe physical harm on the body and psychological harm on the mind. They can negatively affect almost every organ in the body, including the gastrointestinal tract. From severe nausea and vomiting to esophageal erosions and heartburn, gastrointestinal symptoms and complications can range from mild to severe and may be reversible with the appropriate treatment. A study discovered that 98 percent of females with a documented eating disorder fit the criteria for a functional gut disorder and 50 percent of women met the criteria for irritable bowel syndrome (IBS). Functional gut disorders are gastrointestinal disorders without any evidence of anatomical gastrointestinal disease and are very common in individuals with eating disorders.

Gastrointestinal complications associated with eating disorders: 

  • Gastroesophogeal reflux disorder (GERD): Commonly referred to as gastric reflux, results from repeated episodes of self-induced vomiting which results in a weakened lower esophageal sphincter, the anatomical connection between the stomach and the esophagus. When this sphincter becomes weakened, stomach acid and partially digested food travels from the stomach back up to the esophagus resulting in an increased acidity in the esophagus. An increase in acidity can result in a burning sensation and eventually esophageal erosion.
  • Sialadenosis: This refers to swollen parotid glands, which result in repeated episodes of purging (self-induced vomiting). Individuals often present with painful and swollen “chipmunk-like” cheeks.
  • Barrett’s esophagus: This is a pre-cursor to esophageal cancer that results from esophageal erosion when the lower esophageal sphincter weakens. Self-induced purging causes weakening of the lower esophageal sphincter and stomach acid travel from the stomach to the esophagus resulting in erosions and these precancerous lesions.
  • Mallory Weiss tears: Esophageal tears resulting from increased esophageal pressure due to self-induced vomiting.
  • Cathartic colon: The complete shutdown of the bowel (colon) resulting from overstimulation of the bowel. Chronic overstimulation results from laxative abuse. Stimulant laxatives work by irritating the nerves that stimulate the colon resulting in watery stools whereas bulk-forming laxatives work by increasing stool mass resulting in overstretching of the bowel to the point it becomes dysfunctional.
  • Rectal prolapse: Occurs when the rectum protrudes through the anus and results from chronic straining secondary to constipation. Chronic constipation presents in individuals with eating disorders who abuse laxatives and engage in binging and self-induced purging.
  • Delayed gastric emptying: Results when the stomach becomes chronically distended secondary to binge eating and decreased gastric motility.
  • Esophageal and gastric rupture: Individuals who engage in binge eating are at risk for acute gastric dilatation. Acute gastric dilatation occurs due to delayed gastric emptying and when the stomach becomes over distended with food, the stomach loses the ability to empty its content resulting in obstruction of blood flow to the intestine leading to a dead gut and gastric rupture.


This blog was originally published on July 5, 2017 at and is republished here with permission.