Table 2.

Selected medical complications resulting from eating disorders in children affected by obesity.

EDs Behaviors	Medical Complications
Bulimia nervosa
Fluid and electrolytes	dehydration, hypokalemia, hypochloremia, metabolic alkalosis (vomiting); dehydration, hyperchloremic metabolic acidosis, hypocalcemia (laxative use)
Psychiatric	depressed mood or mood dysregulation; obsessive-compulsive symptoms; anxiety; laxative dependance; suicide
Gastrointestinal	gastroesophageal reflux, esophagitis; Mallory–Weiss tears; esophageal or gastric rupture
Dental	dental erosions
Binge eating	obesity with accompanying complications
Anorexia nervosa
Psychiatric	depressed mood or mood dysregulation; obsessive-compulsive symptoms; anxiety; laxative dependance; suicide
Neurologic	cerebral cortical atrophy; cognitive deficits; seizures
Cardiac	decreased cardiac muscle mass, right axis deviation, low cardiac voltage; cardiac dysrhythmias, cardiac conduction delays; mitral valve prolapse; pericardial effusion; congestive heart failure; edema
Gastrointestinal	delayed gastric emptying, slowed gastrointestinal motility, constipation; superior mesenteric artery syndrome; pancreatitis; elevated transaminases; hypercholesterolemia
Endocrinologic	growth retardation; hypogonadotropic hypogonadism: amenorrhea, testicular atrophy, decreased libido; sick euthyroid syndrome; hypoglycemia/hyperglycemia, impaired glucose tolerance; hypercholesterolemia; decreased BMD
Hematologic	leukopenia, anemia, thrombocytopenia, elevated ferritin; depressed erythrocyte sedimentation rate
Fluid and electrolytes	dehydration; hypokalemia, hyponatremia
Refeeding	night sweats; polyuria, nocturia; refeeding syndrome: electrolyte abnormalities, edema, seizures, congestive heart failure (rare)

Adapted from Rosen; American Academy of Pediatrics [208].