The medical complications of eating disorders (EDs) have been described in the literature; however, the pulmonary system has historically been described as relatively spared from the ravages of eating disorders and thus neglected in the literature. Here we review the pulmonary complications that have been described in the literature, including the effects of starvation on the lungs of nutritionally deprived animals and patients with anorexia nervosa. There is clear evidence of weakness of respiratory muscles with starvation in both groups. However, there is discordance in the literature as to whether starvation results in "nutritional emphysema," and if so, by what mechanism and at what degree of malnutrition it develops. We also explore the growing concern for the risk of non-tuberculosis mycobacterium infection as well as risk for pneumomediastinum and pneumothorax in patients with restrictive EDs. From the limited literature, it is clear the lungs, in fact, are not spared and that further research is needed to fully understand the full extent of pulmonary complications instigated by EDs.
Keywords: Anorexia nervosa; Avoidant/restrictive food intake disorder; Binge eating disorder; Bulimia nervosa; Medical complications; Pica; Pulmonary; Rumination.
Eating disorders have many medical complications, however, historically the lungs have been described as spared from these complications. The authors review the available scientific literature and conclude that eating disorders do not spare the lungs as previously described and in fact may place patients at risk for weakness of the muscles that help us breath, changes to the structure of the lung, rare lung infections and potentially life-threatening collapse of the lung.
© 2023. The Author(s).