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How Often Is Anorexia Linked to a Medical Illness?

By December 7, 2012

My daughter was diagnosed with Graves Disease following an extended illness with Mono, and was ill for a total of three months before we got the Graves diagnosis. Following the Graves Diagnosis, approximately two weeks later she was hospitalized for a peirod of one week, with an additional diagnosis of anoxeria. She has now regained some of the fifteen pounds she lost, and is receiving a variety of follow-up care with a Nutritional Doctor, Psychotherapist, and Dietitian, (in addition to the Endocrinologist). However, her Graves Disease is still not managed, and she continues to have no interest in food, and only eats because we encourage her to do so, and only then in minimal quantities. I was wondering how often is anorexia is linked to a medical diagnosis? My daughter didn’t seem to have these issues before she got sick with the Mono, followed by Graves, however, we have seen her shut down like this when she gets sick. I realize that the medication can cause her to lose her appetite, but the Pediatric Endocrinologist tells me that patients with Graves don’t do this, and that usually their appetite increases, while they lose weight due to the hyperthyroidism. I appreciate any input you can provide, as we are still trying to get my daughter’s Graves Disease managed followed by the eating issues. – Amy

Dear Amy,

This is a good question. It is not unusual for an eating disorder to start with a medical illness. There are many medical conditions that a natural consequence of which is weight loss or diminished appetite. In some individuals, this “easy” weight loss can start the cycle of deliberately restricting food for the purpose of continued weight loss.

If the issue is purely medical, as the physical symptoms resolve, appetite is normalized and weight is restored.

If, however, the person refuses to gain back the weight, this could be a sign that an eating disorder may have developed, assuming they are low weight.

Grave’s Disease routinely can cause weight loss. This being said, patients without eating disorders would be eager to try and significantly increase their caloric intake to prevent extreme weight loss.

Sorting out the difference between an eating disorder and a medical cause is very complicated and needs to be handled by health care professionals skilled in treating patients with eating disorders. I encourage you to seek one out in your area.

Best wishes,

Brenda K. Woods, MD FAAFP