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My co-blogger Charlynn over at the Disordered Times recently discovered she has osteopenia, a precursor to osteoporosis, as the result of her eating disorder. She is 26 years old and she has the bones of a woman more than twice her age.

Charlynn gave some great advice to others who may also be at risk: get enough vitamin D, eat calcium-fortified foods and foods rich in calcium, exercise regularly (note, not excessively), drink in moderation, don’t smoke or try to stop smoking, and of course, see your doctor.

Even after one recovers emotionally and mentally from an eating disorder, the ugly physical side effects can still be seen for years to come. This is the side not portrayed in the media glamorization of an eating disorder, but it is the reality nonetheless.

During my disorder, I developed a heart arrhythmia, thanks to abuse of ephedra, malnutrition and use of syrup of ipecac – the latter damages heart muscle and has been blamed for the death of Karen Carpenter, who suffered a heart attack as the result of misuse of the drug. Several years ago, I had to wear a heart monitor 24 hours a day for a full week. Each time I felt palpitations, I recorded them and then called an 800 number to play it back to operators there who sent the results to a cardiac specialist. Luckily for me, I stopped the destructive behaviors before they could do serious damage. I see my doctor once a year to check on my condition, but other than palpitations every so often, it poses no health risk today.

What still poses a significant problem however, is the damage I did to my teeth. I’ve always been vain about my teeth – people usually ask me if I wore braces as a kid because they’re naturally perfectly aligned. Years of purging however has left them brittle, weak and prone to chipping. Stomach acid erodes the teeth’s enamel and dentin, leaving teeth susceptible to decay and infection. I’ve seen photos in which the mouths of bulimics are as ravaged as those of meth addicts. But keep in mind, you don’t have to routinely purge for an eating disorder to damage your teeth. Because people with anorexia often do not get sufficient calcium, the body must find calcium elsewhere and takes it out of body parts such as the teeth and bones.

Once again, I’m lucky in that I haven’t had serious problems, but I do have enamel wear and have chipped two of my teeth, both of which needed to be sanded down. Dental care is important for people with any eating disorder, but especially those with purging disorders. Here are some tips I’ve compiled both from my dentist and other dental specialists:

• This one is a given: Stop purging. Easier said than done, I know. If you cannot stop purging, work on reducing purging. Here are some tips that might help. And of course, seek out professional help for your eating disorder.
• Maintain regular dental care, both at home and professionally. See your dentist every six months and try to be honest with them about your condition if you feel comfortable doing so. Dentists are notoriously kind of clueless about eating disorders. I had one who never suspected, or at least, never led on that he suspected. I told my current dentist about my condition and he didn’t seem to know how to respond. Sometimes it’s easier to tell the dental hygienist beforehand, so she can notate it on the chart.
• Do not brush teeth after vomiting; it will lead to excessive enamel erosion. Instead, rinse mouth with water and then drink milk or eat cheese to counterbalance stomach acid. If these foods trigger a binging panic, just stick with the water.
• Brush with fluoride toothpaste, floss and and use a fluoride rinse every day. This will help strengthen enamel and prevent tooth decay. I prefer ACT for kids, which tastes like bubble gum.
• If you have serious tooth decay, see your dentist. Dentists today can do miraculous things to give the effect of beautiful and healthy teeth, whether it be caps, crowns, resins or veneers. This can be costly, though, and not all insurance companies cover these procedures.

There are some other basic preventative health measures people with eating disorders should take, regardless of stage of recovery:

• Drink plenty of water. Dehydration is one of the most dangerous side effects of an eating disorder, for it can wreck havoc with electrolyte levels, chemical imbalances in the brain, the heart and more. Terri Schiavo is thought to have suffered a heart attack brought on by an electrolyte imbalance from bulimia.
• Take nutrition/vitamin supplements. Dieting and eating disorders cause vitamin deficiency, which in turn, can strengthen and reinforce an eating disorder. Some medical professionals recommend taking a well-formulated daily multivitamin supplement, with at least 1,000 mg per day of vitamin C, plus additional B-vitamins. Note: vitamin supplements should not be used in place of eating foods with vitamins, but they should especially be used by someone with an eating disorder who has difficulty in eating a balanced diet.

Keep in mind: Drinking water and taking a vitamin while in the midst of an active eating disorder is like dropping sandbags on the levees and New Orleans and hoping for the best come the next Katrina. Eating disorders can cause a multitude of serious ailments and illnesses and the best way to prevent them is to stop the eating disordered behaviors entirely. Taking a vitamin and remaining hydrated will not stop the hair loss, the skin problems, organ failure, depression, malnutrition or the general breakdown of the body caused by an eating disorder. I offer the above only as recommendations on how someone actively struggling with an eating disorder can maintain some degree of good health while pursuing recovery. As always, I am not a doctor and you should see yours for professional advice.