Many parents and patients alike ask me how someone with ED can be so sick, yet they look healthy and their blood tests are normal. Of course, there is not one answer to this question. But, we do know that the body is extremely good at adapting to changes and surviving. The body fights and fights to keep the patient alive, even when severe damage is occuring on the inside. (http://bjp.rcpsych.org/content/194/1/10.short)
What causes death in ED patients? Eventually, the body cannot sustain life anymore and fails to thrive. This can be because it no longer has enough energy to keep the person functioning. A lot of the causes of death can also be related to the effects of ED on the organs. For example, the kidneys cannot function properly and may shut down, which can be deadly. The brain does not have enough glucose and starts turning off. The lungs cannot bring enough oxygen and nutrients to the body, so the organs lose their nutrition. The heart muscle becomes too weak to pump, which in itself is a fatal emergency. The body also becomes too weak to fight off infections, which puts the patient at risk for many illnesses that they could normally fight off. Pneumonia is a big problem in these patients, especially if their breathing is interuppted because of a loss of muscle mass.
(By the way...the picture on the side says 'hope', but when you flip it over, it says 'faith'! COOL!)
Now that we have talked about physical causes of death, we need to consider the other factors that come into play - mental and emotional well-being. Many deaths from ED - like other mental illnesses - can be attributed to suicicde. Why? The patient has lost all hope and feels trapped. They want to get better but are scared to gain weight and to eat, or to seek help. They are tired because they are starving but cannot eat. They are weak but cannot find the power to eat something to sustain them. They are frustrated because no one seems to understand them, and others blame them for their problems. They are angry at themselves because they believe that this is their fault; that they are no good and should be ashamed of themselves. They hope to end their lives because they feel that they are a burden on everyone around them. Sound extreme? I am not exaggerating - this is exactly what patients with ED feel like. Sometimes, these feelings get too strong that the patient believes that the only way to end their misery and pain is to die. It is unforunate, but this happens too frequntly. Can this be prevented? Likely. With encourgament, the patient can see that they have a reason to live, and that ED does not need to control their lives forever. It takes time, but with enough support, the patient can start to see that life is worth living, and that ED is NOT a part of their future.
Whatever the cause of death may be, patients must know that ED is serious and that it can kill them anytime, often without warning. The body can only withstand so much damage until it fails. Likewise, the patient can only take so much pain (physical, mental, and emotional) until they crash and want to end their misery. While I never made attempts to kill myself, I did have days when I was sick when I felt that I just wanted my life to end because it was hopeless. Even in recovery, I still had days when I felt awful and tired and angry. But things got better, and today, I am happy with my life, and I am doing all that I have ever wanted to. Life truly does get better in recovery, but it takes time. Until that time comes, patients need to have support and proper treatment. They need to know that they are ill even if they don't feel 'sick enough'. They need to know that ED should not and WILL not be a part of their lives forever. They need to have hope, faith, and perseverance. Because without hope, you can never see a bright future. Without faith, you will depend on yourself alone for success and never realize that God gives us strength. Without perseverance, you may be discouraged by falls and think that you will never achieve yout dreams. But with the three of them, you will be well on your way towards recovery, healing, and strength.