The risk for early death is twice as high in bulimic anorexics as it is in the anorexic-restrictor types. Patients who are at the lowest weights when they are first treated are in the greatest danger. The study, however, only looked at death records of all women, which listed accompanying anorexia but which might have missed many unrecorded cases of anorexia. Other risk factors for early death include being sick for more than six years, previous obesity, personality disorders, and dysfunctional marriages. Males with anorexia are at particular risk for life-threatening medical problems, probably because they are diagnosed later than are females.
Heart disease is the most common medical cause of death in people with severe anorexia.
The heart can develop dangerous rhythms, including slow rhythms known as bradycardia. Blood flow is reduced and blood pressure may drop. In addition, the heart muscles starve, losing size. Cholesterol levels tend to rise. Heart problems are a particular risk when anorexia is compounded by bulimia and the use of ipecac, the drug that causes vomiting.