Eating Disorders & The Dangers They Pose to the Musculoskeletal System

Can disordered eating harm your bones and muscles?

Anorexia and Bulimia (eating disorders centered around food restriction) pose serious risks to the musculoskeletal system. Prolonged malnourishment can weaken bones, and people suffering from eating disorders also often push themselves to work out excessively. This can increase the risk for injuries, and lead people to ignore them until they become severe, even to the point of requiring surgical intervention. 

The Risk of Osteoporosis 

Severe calorie deficits can lead the body to stop producing important hormones such as estrogen (in women) and testosterone (in men). In both cases, the hormone deficiency can contribute to decreasing bone mass. In adolescents, this can result in a person never reaching peak bone density, potentially causing issues later in life. For both adolescents and adults, the decrease in bone mass can lead to osteoporosis, which in turn greatly increases the risk of suffering fractures. You can’t really tell what is happening from the outside, you won’t feel or see the difference in your bones. Osteoporosis generally can’t be diagnosed without special imaging tests like a Dual-energy Xray Absorptiometry (DXA) scan. The risk of osteoporosis remains even if someone has ceased disordered eating behaviors. 

What Can You Do If You Have or Have Had an Eating Disorder?

If possible, early recognition and treatment of disordered eating is the best course of action. Seek professional help to assist in establishing healthier attitudes and behaviors around food and food restriction. Preventing long term musculoskeletal damage in this way is much better than trying to recover from injuries or living with osteoporosis later in life. But if you’ve engaged in food-restricting behaviors for any significant length of time you should have a bone density test and be sure about whether or not you’ve lost bone mass. 

As you recover from an eating disorder, a physical therapist can help you with some strengthening exercises and work with you on body mechanics to promote safe movement. The purpose of this work is to reduce the risk of falls, strains, or other traumatic injury which can fracture bones which have potentially been weakened by osteoporosis. They may also advise on nutrition to help you reach and maintain a healthy weight which normalizes your hormone levels. Working with a professional can improve your relationship with your body and help you avoid relapses that could cause further damage. Recovering from an eating disorder can be a lifelong journey, but with the right support system you can find the ability to thrive and be healthy. 

Eating disorders develop from ongoing nervous system dysregulation. When we are stressed all the time and we have unresolved trauma our nervous systems stay in fight or flight or fawn or freeze chronically. This impacts our relationship with our bodies and food because our hunger and satiation cues and body image all live in the brain which is part of the nervous system. In order to change our behavior related to food and our bodies we have to learn to regulate our nervous systems. The Befriending Your Body Program focuses on this often overlooked part of eating disorders. When we are grounded and calm we can quiet the criticism in the mind, learn to listen to the needs of our bodies and make choices that support strength and health. To learn more about this program visit Heather's Healing Kitchen and register for the virtual summer program which begins June 25th and will be held for 8 consecutive Wednesday nights.