Researchers Astonished by Anorexia Death Rates.  Can Fasting and Weight Loss Cause a Deadly Mental Illness?

Robert Buran Anorexia  By Robert Buran

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Anorexia or Anorexia nervosa, as psychiatrists know only too well, is a dangerous illness with a high rate of premature death.

But exactly how dangerous has become clearer—the result of a nationwide longitudinal study conducted by Swedish scientists.

Those of us who fast regularly, and as in my case for long periods of time, may be worried OR WORRY OTHERS because of our fasting behavior.  “Slipping into” this disease and in some cases dying from this disease may form a basis for some of those fears.

I am academically trained in psychology and practiced psychology and was involved with treatment for about 15 years before I went into finance in 1988.  Given both my fasting background and academic and professional background, I naturally have great interest in the mental illness known as anorexia nervosa.

IwontEat AnorexiaFirst of all this disease may be the worst mental illness known to psychiatry.  It kills a higher percentage of its victims than any other mental illness known. Just how bad it is becomes clear in reviewing the following 30 year study that was done in Sweden.  The Swedes have a unique form of socialist government that assigns a person a number at birth and the same number follows them until death and enters with them into every doctor’s office and hospital as well.  It makes Sweden the perfect place to do an accurate 30 year longitudinal study on this disease.

These are some highlights from the study:

Out of the cohort studied, 265 women died during the 30-year follow-up. The most frequent causes of death were suicide (responsible for 32 percent of the deaths), anorexia (19 percent of the deaths), and cancer (11 percent of the deaths). The remaining 38 percent of deaths were caused by other illnesses or by homicide. The average age at death for the 265 anorexia patients who died was 34 years.

The researchers also compared findings for their anorexia patients during the 30-year follow-up period with those of the general Swedish population. For example, compared with the general population during this time, anorexia subjects were 19 times more likely to have died from psychoactive substance use, primarily alcohol use, 14 times more likely to have died from suicide; 12 times more likely to have died from respiratory diseases, 11 times more likely to have died from urogenital diseases, five times more likely to have died from gastrointestinal diseases, and two times more likely to have died from either cardiovascular disease or from cancer.

Altogether, anorexia patients were six times more likely to have died during the 30-year follow-up period than was the general population.

Reference: Psychiatric News, February 06, 2009, Volume 44 Number 3 page 20-29

I would like to add that effective treatment for this mental illness is astronomically expensive and health insurance will not pay all of it.  Treatment for mental illness this severe involves hospitalization and often hospitalization for long periods of time.  Treatment cost as high as a half million dollars per patient is not unusual.  Few girls get the treatment they need.

Given these grim statistics are we in danger of becoming anorexic by fasting?  Is fasting for long periods of time dangerous?  Is getting really skinny going to cause us serious emotional difficulties or make us mentally ill?

In order to dispel that fear let me point out a few facts.


1)      Anorexia nervosa is a mental illness caused by genetic and environmental factors and is not caused by weight loss.  It is highly unlikely that any amount of weight loss, in and of itself, can cause anorexia nervosa.  Nobody with reasonably normal mental health is going to “slip into” a mental illness because of dieting and weight loss, even extreme dieting and weight loss.  Anorexics are already predisposed to mental illness before the disease manifests itself.   It is only later that their mental illness manifests itself in the form of the mental illness known as anorexia nervosa.

2)    This disease is a very serious illness, but it is also quite uncommon affecting no more than six tenths of one per cent of the general population.  Contrast this against the huge health risks for a population where 60% or more are over weight and run risks of contracting cardiovascular problems, diabetes and a myriad of other physical and psychiatric difficulties due to being too fat.

3)      Because anorexia nervosa is a serious mental illness its diagnosis requires psychiatric evaluation.  It is quite impossible to diagnose a mental illness such as anorexia nervosa with a scale and tape measure.  Many very slender people are very healthy and run no risk of becoming mentally ill simply because they are slender.  Statistically you are far more likely to be healthy if you are underweight than if you are overweight.

4)      Even anorexics would possibly be reasonably healthy were it not for stress.  Mental illness places stress upon their bodies that prevents them from realizing the health benefits of being very thin.  The stress comes from anxiety and most anorexics are to some degree suicidal.  This makes the anorexic prone to other diseases and psychiatric problems.  In spite of this fact most anorexics do not die of being too thin.  Suicide remains the number one killer followed by alcohol abuse and drug abuse.

The conclusions we can draw from these facts relative to fasting is pretty obvious.  An intelligent adult runs virtually no risk of “falling into” a mental illness like anorexia nervosa by fasting.  This is true even if that individual takes fasting to somewhat extreme levels and reaches a body weight that some may regard as anorexic.  Fasting and weight loss does not cause mental illness.

Fasting and weight loss is natural and healthy.  Fasting and weight loss rejuvenates the body AND the mind.  In our overly abundant food society and given the choice between eating and not eating you are still more likely to enjoy health benefits by abstaining from food for periods of time and not eating as opposed to eating.

Anorexia nervosa is no reason to avoid fasting regardless of your height and weight.


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