Eating disorder at root
of Terri Schiavo case

NEW YORK - Beneath all of the controversy surrounding the Terri Schiavo case is an important detail about what brought on her condition in the first place: complications from an eating disorder that caused heart failure and led to severe brain damage.

Schiavo's case is tragic for innumerable reasons, but it should also serve as a wake-up call that eating disorders can have serious, sometimes fatal consequences.

Robert Bazell, NBC News’ chief science correspondent, explains the dangers of eating disorders and why Schiavo's case should be a cautionary tale to many.

How is it that an eating disorder can lead to heart failure and, in the extreme case of Schiavo, a vegetative state?
Well, fortunately, it is very rare that this can happen. But when people have bulimia, which is what Terri Schiavo is reported to have had, people eat large amounts and then purge themselves by either vomiting or using laxatives extensively.

Test yourself Do you have an eating disorder?

Bulimia can cause a sudden dehydration of the body that causes an imbalance in electrolytes, and particularly potassium. When that happens, it can cause irregularities in the electrical signal, so it can cause the heart to stop beating. That is reportedly what happened to Terri Schiavo.

No one really knows how prevalent eating disorders are in the [U.S.] population. There have been reports that it is from 1 percent of the entire population in the United States to up to 7 percent of young women in America. So, it is an extraordinarily common problem, which is not surprising given our obsession with body image and the problems with being overweight that we are challenged with all the time.

How common is it for eating disorders to lead to this sort of complication?
The two major kinds of eating disorders are anorexia, where people basically just starve themselves, and bulimia, which is what Terri Schiavo is reported to have had.

There are more reports of people hurting themselves with anorexia because clearly, they are just simply starving and they can get into a lot of medical trouble.

However, there are plenty of reports of people who do have bulimia, like Terri Schiavo, [suffering serious consequences]. [The rate of complications] is not one in 100 or anything like that — it’s fairly rare. But because the consequences can be fatal, it is certainly something that needs to considered when someone is questioning whether or not an eating disorder is something to be worried about it. It is.

What are some of the other long-term effects of eating disorders?
We need to remember that men suffer from eating disorders, too. But clearly it is more common in women.

The biggest thing with bulimia is that because people vomit, it rots their teeth. But the other major problem is that there are all kinds of psychological consequences. It has to do with people having a bad self-image and a lot of psychologists and psychiatrists believe that if you don’t treat the underlying problems that are causing it, then you don’t cure the disease.

Also people who vomit constantly can have damage to their esophagus, as well as their teeth.

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