How Eating Disorders Affect Heart Health

An inner look at what happens to your cardiovascular system during an eating disorder.

What happens to your heart during an eating disorder? Why do eating disorders cause heart failure in some cases? Why does malnutrition slow your heart rate? Can a damaged heart from an eating disorder heal?  

These aren’t questions people typically ask in the early stages of an eating disorder, and health professionals need to provide more awareness. How eating disorders affect the heart is one of the most dangerous and life-threatening complications of these illnesses. In fact, cardiac arrest and heart failure are leading causes of death in those with anorexia nervosa.  

In this post, we’ll explain how eating disorders affect the heart, the reasons behind these effects, signs of heart complications, and eight strategies for preventing heart damage from eating disorders and supporting the heart during recovery. Whether you’re struggling with an eating disorder, supporting someone who is, or simply want to understand more, this post will guide you with compassion, empathy, and clinically credible information. 

Key Takeaways

• Eating disorders can cause life-threatening cardiovascular complications.  
• Malnutrition can lead to heart muscle shrinkage and a slow heart rate (bradycardia). 
• Purging behaviours in bulimia can cause electrolyte imbalances that lead to arrhythmias and sudden cardiac death.  
• Heart symptoms may include chest pain, dizziness, fainting, and heart palpitations. 
• Recovery is possible, but refeeding must be done carefully to avoid refeeding syndrome.  
• Heart issues from eating disorders can improve with weight restoration and treatment.  
• Compassionate, professional medical support is key to recovery. 
• It’s never too early to seek help. 

How the Heart Works And Why Nutrition Matters 

The heart doesn’t just beat on its own. It relies on finely tuned electrical signals and muscle contractions that are influenced by hormones, nervous system activity, electrolyte levels, and nutrient availability. At the cellular level, sodium (Na⁺), potassium (K⁺), calcium (Ca²⁺), and magnesium (Mg²⁺) are crucial for generating action potentials and maintaining normal heart rhythm, as explained in more detail here. 

When your body is starved or imbalanced due to disordered eating behaviours, these systems break down—and your heart is one of the first organs to suffer. This is a key reason why eating disorders affect the heart so severely. 

How Different Eating Disorders Affect the Heart

Anorexia Nervosa: A Starved Heart

In anorexia nervosa, caloric restriction and malnutrition cause the heart muscle to shrink (cardiac atrophy). As a survival mechanism, the body slows the heart rate to conserve energy. This condition, called bradycardia, means a resting heart rate of less than 60 beats per minute—sometimes even below 40 in severe cases. Bradycardia in anorexia is a common and serious physiological adaptation to prolonged starvation.

Additionally, low blood pressure, cold extremities, fainting, and arrhythmias are common. Starvation reduces the amount of available glucose and electrolytes the heart needs to beat efficiently. In some cases, anorexia can cause sudden cardiac death, especially if electrolyte levels become dangerously imbalanced. 

Bulimia Nervosa: The Risk of Electrolyte Imbalance 

People with bulimia often engage in purging behaviors like vomiting or laxative abuse, which cause a dangerous loss of potassium and other electrolytes. This can trigger arrhythmias (irregular heartbeats) and even heart failure. 

One especially dangerous condition is hypokalemia (low potassium), which can cause life-threatening ventricular arrhythmias, chest pain, and sudden cardiac arrest. Frequent vomiting also affects acid-base balance, placing added strain on the heart . 

Binge Eating Disorder and Atypical Eating Disorders

Although often less discussed, binge eating disorder and avoidant restrictive food intake disorder can also impact cardiovascular health. Mental distress such as trauma, discrimination, impulsivity, body dissatisfaction/weight stigma, and hyper fixations can result in compulsive coping tools, e.g., binge eating and/or food aversions.

Drastic fluctuations or a lack of variety in eating patterns throughout the day or week can contribute to nutrient deficiencies, hypertension, insulin resistance, heart disease, and poor heart rate variability, as discussed in more detail here.

How Eating Disorders Affect the Heart: Symptoms You Shouldn’t Ignore

• Postural Orthostatic Tachycardia Syndrome (POTS): Common in people with eating disorders, POTS occurs when blood flow is insufficient when standing, leading to dizziness, rapid heartbeat, and fainting.  

• Heart palpitations, arrhythmias, and/or chest pain from dehydration or electrolyte imbalances.  

• Swelling in the legs or ankles may indicate early signs of heart failure.  

• Fatigue and shortness of breath frequently stem from low blood pressure or weakened heart muscles caused by prolonged malnutrition.

• Easy bruising and intolerance to cold due to a lack of circulating oxygen. 

• Low blood pressure and bradycardia in anorexia (a heart rate under 60 BPM), especially when accompanied by weakness or fainting.

Can the Heart Heal from an Eating Disorder?

The short answer: Yes, but with caution and medical supervision. Preventing heart damage from eating disorders during recovery starts with safe nutritional rehabilitation. Reintroducing food must be done slowly to avoid refeeding syndrome, a dangerous condition where shifting electrolytes can cause sudden heart failure during recovery. 

As Dr. Philip Mehler, a leading expert in medical complications of eating disorders, explains: 

“Bringing someone with an eating disorder back to a healthy weight can resolve structural changes to the heart caused by malnutrition, but it must be done cautiously”

Recovery also involves learning compassionate nutrition, restoring electrolytes, healing mental health, and addressing the underlying causes of disordered eating—not just the behaviors. These steps are essential for both full-body healing and long-term heart health in eating disorder recovery. 

Caring for Your Heart During Eating Disorder Recovery: 8 Essential Strategies 

Supporting your heart during eating disorder recovery is critical for long-term health and healing. Below are eight clinically sound strategies to help protect heart health during eating disorder recovery: 

1. Assemble a Multidisciplinary Treatment Team

Create a list of health professionals for your eating disorder recovery, including a doctor, registered dietitian, and therapist. You can also include massage therapists, acupuncturists, athletic therapists, etc, to support holistic care. Be sure all health professionals on your team are experienced with eating disorder care.

2. Monitor Electrolytes with Regular Bloodwork

Ask your doctor to monitor your electrolytes through regular bloodwork—especially during weight restoration.

3. Stay Hydrated to Support Circulation

Maintain proper hydration to support healthy blood volume and circulation. Aim for 35ml/kg body weight.

4. Avoid Intense Exercise Until Medically Cleared

Overexertion in a malnourished body can be dangerous and have a high risk of injury.

5. Follow a Gentle, Supervised Refeeding Plan

Focus on gentle refeeding, guided by dietitian’s who are familiar with refeeding syndrome prevention.

6. Eat a Variety of Heart-Supportive Foods

Including one’s rich in magnesium (pumpkin seeds, beans, spinach), potassium (potatoes, oranges, avocado), and calcium (fortified milk-based products or milk alternatives, almonds, broccoli) to support heart rhythm. See our blog post on Nutrition for a Healthy Heart.

7. Manage Emotional Stress

Mindfulness, therapy, and support groups can reduce strain on the heart.

8. Practice Patience and Compassion with Your Body

Healing takes time, but recovery is possible. Progress may be slow and challenging, so it’s important to allow yourself space without pressure.

Protecting Your Heart Starts with Seeking Help

The impact of eating disorders on the heart is serious and too often misunderstood. Whether it’s anorexia and heart damage, bulimia heart risks, or general cardiovascular effects of eating disorders, the damage is real—but so is the possibility of healing.

Early detection and treatment can make all the difference. With proper care and a compassionate approach, the heart can recover—along with the body and mind. 

If you or someone you love is struggling with disordered eating, it’s never too early to ask for help. Start by asking yourself:  

• Do you use food to cope with stress or loneliness?  

• Are you preoccupied with food, weight, or your body?  

• Do you feel out of control when you eat or feel guilty afterward?  

• Do you avoid eating, eat in secret, or purge?  

• Do you feel like food has taken over your life?  

If you answered “yes” to any of these, please reach out to a healthcare provider. Your heart—and your life—are worth protecting. 

Need Help Navigating Recovery? We’re Here.

Concerned about how your eating disorder is impacting your heart health? We’re here to help.

Eating disorders like anorexia, bulimia, and binge eating disorder can take a serious toll on your heart—and your overall well-being. If you’re worried about the physical effects of disordered eating, including heart-related symptoms, our team of Eating Disorder Dietitians can support you. Learn more about our eating disorder dietitian programs or simply book your free discovery call below.

We provide compassionate, confidential care that meets you where you are in your recovery journey. Don’t forget to check your health insurance! Many insurance plans cover Dietitian services.

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