Eating disorders and voice disorders have always been seen as related to physiology and, specifically, to trauma inflicted on the vocal cords during purgation processes, acts during which gastric contents can enter the larynx.
Vomiting, if excessive in frequency and effort, often causes relaxation of the lower esophageal sphincter, resulting in the flow of gastrointestinal fluids into the esophagus.
The most common eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder.
Anorexia nervosa: A disorder in which individuals limit their calorie intake that presents with excessive weight loss, abnormally low body mass index, and malnutrition. This condition becomes harmful to overall health. Associated with this disorder are body image distortions, in which individuals either perceive themselves as significantly larger than is realistic or fail to recognize their weight as significantly below average. Anorexia nervosa can be divided into two different subtypes, a restrictive subtype and a purgative subtype. The restricting type indicates that weight loss is due to dietary restrictions, while the purging subtype indicates continued engagement in purging behaviors such as vomiting, exercise, laxatives, or any combination of these within the past 3 months.
Bulimia Nervosa: eating disorder with characteristic binge and purging behaviors.
These eating disorders have a more complicated relationship, with symptoms of bingeing, purging, and restricting occurring in both.
Few studies actually link anorexia nervosa with voice disorders due to vomiting, rather they link vocal quality with anorexia.
It is logical to assume that the physiology of bulimia nervosa lends itself to voice disorders given its obvious symptom of purging through vomiting. An abnormal accumulation of mucous secretions in the larynx and piriform sinuses was reported in a study of women diagnosed with bulimia nervosa.
In studies conducted over the years, all eating disorder groups have shown higher prevalence rates of voice disorders than the general population, with anorexia nervosa demonstrating the highest prevalence (23%). Furthermore, the results revealed that the exercise purging behavior, as opposed to vomiting, was a risk factor for voice disorders.
Possible reasons for the connection between eating disorders and voice disorders therefore include not only purging but also malnutrition, dehydration and anxiety, although these elements are still being researched.
Valentina Carlile - Osteopath expert in Osteopathy applied to voice and speech disorders since 2002. For information and reservations visit the page Contacts