Medical Center for Eating Disorders

"You’re an athlete! That’s why your heart rate is low…”

Or is it?

In athletes with eating disorders, bradycardia (slow heart rate) is often mistaken to be a sign of an “athletic heart”.

A common presumption is the slow heart rate is due to having a high performing heart as a result of athletic activity.

In *true* athletic hearts, the muscle is strong, the heart pumps vigorously, the chamber size is larger, and the heart can pump out more blood per beat.

In a malnourished athlete with an eating disorder, the heart muscle can actually be breaking down. This is due to not eating enough and/or the amount of exercise exceeding the body’s capacity to replenish through food sources. Smaller weaker heart muscles are unable to handle the same workload and will therefore slow down to compensate.

A higher heart rate requires more energy (food) so in a malnourished state the body combats this by slowing down the heart rate, slowing the metabolism and conserving energy.

If the examining physician does not screen for clues of a malnourished heart, then the clinician may misinterpret the slow heart rate as a sign of “athletic heart syndrome."

Waking up in the middle of the night sweating is abnormal.

In the presence of malnutrition, it is likely a symptom of hypoglycemia.

Why does low blood sugar make you wake up sweating?
Our blood sugars naturally drop the lowest in the the middle of the night. When your blood sugar drops too low, your body has a stress response that causes sweating. This will wake you up and alert you that you need to act quickly because hypoglycemic episodes are no joke and may lead to seizures or a coma (which we may not realize if we were sleeping!).

Here's something common we hear when discussing night sweats or hot flashes:
"I wake up in the middle of the night sweating, but it's probably just because I live in Texas... my comforter is too thick... I need to turn the fan on... etc."

While some of those may be true (we get it, we live in Texas too!), if it happens more than once or frequently, then chances are it's actually your body trying to wake you up from low blood sugar. This needs to be addressed before you fall back asleep with a carb/protein snack, such as a peanut butter sandwich or cheese and crackers. Make sure your medical provider and dietitian are kept in the loop if this is happening!

We aren't here to replace your primary care doc. We are here to be the specialists in eating disorders, collaborate with all of your providers on how to best support you, and advocate for you (because eating disorders aren't a required topic in medical school unless the speciality is adolescent medicine!).

We're here when you're ready!

Did you know that eating disorders affect every organ system in our bodies?

Yep, you read that right.

When we engage in eating disorder behaviors that throw our body out of its homeostasis (such as restricting intake, purging, overexercising, taking laxatives, etc.), our whole body becomes aware of these changes and start making changes (that we may not even be aware of!) in order to keep us safe.

Our bodies are so smart 👏🏼

And our bodies may be able to maintain these changes for a short period, but what our bodies truly want is to be back in homeostasis where everything is functioning as normal.

If eating disorders behaviors aren't changed, eventually we will start to become aware of these changes, especially if we really pay attention to what our body is telling us.

What are some ways the systems in our body are impacted? Slowed heart rate, slowed metabolism, retention of water, hair loss, acrocyanosis (or bluish/purpleish fingers and toes), and abnormal labs just to name a few.