Adults who have severe anorexia and/or bulimia can have physical and mental symptoms that interfere with their ability to work. Anorexia is an eating disorder that is characterized by extreme limited food intake, excessive weight loss, and an irrational fear of gaining weight. Bulimia is an eating disorder characterized by binging and purging through vomiting, laxatives, or extreme exercise. These two eating disorders often occur together and increase the complications that can occur for an individual.
Problems Caused by Anorexia and Bulimia
Those who suffer from anorexia and anorexia with bulimia can often be easily identified by their major weight loss and low body weight. There are several complications that can arrive from anorexia and anorexia with bulimia. Complications include:
- Heart disease, including:
- dangerous heart rhythms, including slow heart beat
- reduced blood flow and pressure
- decrease of the heart size due to starving of the heart muscle, and
- imbalance of electrolytes, which are responsible for keeping your heart beating regularly. If electrolytes are not rebalanced quickly, it can lead to death.
- Other physical problems, including:
- loss of muscle tone and strength
- bone problems
- osteopenia, which is the loss of bone minerals
- osteoporosis, which is the loss of bone density, and
- organ failure.
- Changes in hormones, including:
- reproductive hormones
- thyroid hormones, and.
- stress hormones
- Psychological effects, including:
- anxiety, and
- drug and alcohol abuse.
- Neurological problems
- difficulty organizing thoughts, and
- numbness and tingling in the hands and feet.
- Blood problems, including:
- anemia, and
- pancytoperia, decrease in the production of blood cells by the bone marrow, which can be life threatening.
There are also complications that are particular to bulimia, including:
- Dental problems
- Esophageal problems, including rupturing of the esophagus
- Fluid loss that leads to very low potassium levels, which can lead to severe weakness, paralysis, or dangerous irregular heart rhythms, and
- Weakening of the rectal wall, which can be life threatening and requires surgery to repair.
Qualifying for Disability Benefits
When anorexia, bulimia, or a combination of the two begins to affect your ability to function or maintain a job, you may be eligible to receive Social Security Disability benefits. In order to qualify for Social Security disability or SSI disability benefits, you must meet the requirements of a disability listing, have a condition that is equivalent to one of the disability listings, or prove that you are unable to do any work. (This article discusses how an adult can qualify for disability benefits; for information on getting disability benefits for someone under 18, see our article on SSI benefits for children or teenagers with eating disorders.)
Having a BMI that satisfies the requirements of the listing for weight loss due to a digestive disorder is the most likely way to meet a listing when you have anorexia.
Meeting an Adult Disability Listing
Adults applying for disability benefits for an eating disorder will find that, unlike for those under 18, there is no disability listing for anoreixa or bulimia for those over 18. Instead, Social Security will evaluate your medical condition under disability listings for any mental and physical impairments that accompany your disease. Some of the physical listings that may be met by anorexia, bulimia, or a combination of both include:
- listing 1.06/1.07: broken bones (caused by loss of bone density)
- listing 5.02: gastrointestinal bleeding requiring blood transfusion
- listing 7.02: chronic anemia
- listing 4.02: chronic heart failure
- listing 4.05: recurrent arrhythmias, and
- listing 9.00: endocrine disorders.
If you don't meet one of the listings for physical impairments, you may meet a listing for mental impairments, such as listing 2.02, organic mental disorders. To meet this listing, you must generally show that a mental impairment has significantly impacted your ability to function day to day over a period of time, despite treatment. For more on this listing, please see our section on mental illness.
Equaling a Disability Listing
If you have an impairment that is very similar to one of the listed impairments, and is equivalent in both severity and duration to the listed impairment, you could get approved for disability by "equaling" the listing.
Those with anorexia or anorexia with bulimia may be able to equal listing 5.08, weight loss due to any digestive disorder. In order to meet this listing, you must prove that despite ongoing treatment:
- Your malnutrition is caused by a digestive tract disorder, and
- Your body mass index (BMI) is less than 17.50 when taken at two consecutive times at least 60 days apart but within a six month time period.
For those with anorexia or anorexia with bulimia, the cause of the malnutrition is self-induced; therefore, they will not be able to meet this listing. However, if the impairments caused by the anorexia or anorexia with bulimia is so severe that you meet the required BMI and are unable to do work, you could equal this listing. You should provide medical evidence as to the treatments you are receiving or treatments that you have tried that have been unsuccessful and the impairments you have that are due to the malnutrition.
For those with bulimia, they may not be able to equal this listing if there is not the required low BMI.
If your eating disorders has caused seizures, another listing that might be equaled is listing 11.02/11.03, for epilepsy.
Lack of Ability to Work
In assessing one’s ability to work any job, Social Security will look at physical, mental, and sensory impairments using the Residual Functional Capacity (RFC) form. This form, in addition to your age, education, and work experience, will all be considered when assessing your ability to work.
For those with anorexia or bulimia, fatigue due to the lack of calories provided to the body and hormone imbalances will significantly affect their ability to do physical work. Weak muscles and bones, heart problems, neurological problems (including seizures), and blood problems (including anemia) could all prevent physical work based on their severity. However, work behind a desk may something that one with anorexia or bulimia can do.
As to mental impairments, for people with eating disorders, obsession with food, depression, anxiety, and drug or alcohol abuse could all impact their ability to function properly in a workplace. Additionally, neurological problems caused by the malnutrition, including difficulty organizing thoughts, confusion, poor memory, and poor judgment, could impact their ability to understand and complete tasks.
For more information on how Social Security uses a formula to assess your RFC, age, and education to determine whether you are entitled to disability benefits, see our section on how Social Security decides if you can work.