Which of the following is NOT listed as a long-term complication of anorexia nervosa?

• A. Malnutrition
• B. Increased or decreased BP
• C. Fistula and hemorrhoids
• D. Diabetes mellitus

Answer: (D)

Long-term anorexia nervosa causes widespread problems from sustained malnutrition, affecting heart rate and blood pressure, bone density, hormonal balance, and gut function. Among the listed options, diabetes mellitus isn’t a typical consequence of the chronic undernutrition seen in anorexia nervosa. Obesity-related insulin resistance and type 2 diabetes are more closely tied to excess caloric intake, whereas starvation can lead to low insulin levels and hypoglycemia rather than a persistent hyperglycemic state. Refeeding can cause transient metabolic shifts, including hyperglycemia, but that is a short-term risk, not a chronic complication of the disorder itself. Malnutrition is clearly a long-term issue, and autonomic and cardiovascular changes like altered blood pressure are well documented. Fistula and hemorrhoids can arise with severe constipation or straining but are not standard long-term complications of the condition.