In some extreme cases, spoons or sticks used to induce vomiting have becomestuck in the digestive tract and have had to be surgically removed. Systemic physiological changes in those suffering from anorexia include thyroid dysfunction, disturbances in the heartbeat, and irregularity in the secretion of growth hormone and the hormones cortisol, gonadotropin, and vasopressin. Eventually, if anorexic behavior goes on long enough, classic complications associated with starvation appear. Electrolyte imbalances brought on by insufficient potassium and sodium levels cause dehydration, muscle spasms, and, ultimately, cardiac arrest. If laxatives are used, these further deplete the body of potassium.
Chronic hypokalemia can cause an irregular heartbeat, which can lead to heart failure and death.
Initially, anorexia nervesa was thought to be strictly a psychological problem. However, in the last few years, medical scientists and nutritionists have identified several physical components as well. For example, people with eating disorders have been found to have chemical imbal-ances similar to those found in individuals with clinical depression. Some cases of anorexia have been found to be caused by severe zinc deficiency. As researchers have become increasingly aware of the physiological elements of anorexia, the psychological ones continue to be important.