Why Dizziness and a Racing Heart Can Be Part of Eating Disorder Recovery

"The cardiovascular complications in eating disorders are primarily linked to malnutrition... most cardiovascular abnormalities are fully reversible with nutritional restoration."

— Friars et al., Journal of Eating Disorders, 2023

If you or your child has been in eating disorder treatment and is experiencing dizziness when standing, a racing heart, or fatigue, you may have heard the term POTS. These symptoms are real and they are worth taking seriously -- but eating disorder medical specialists are clear that in the context of active malnutrition or incomplete weight restoration, they are most often a direct consequence of the eating disorder itself, not a separate condition requiring separate treatment.

Research shows that the majority of patients admitted for eating disorder treatment arrive with significant heart rate instability on standing -- and that these symptoms improve substantially with nutritional rehabilitation. The key word is "substantially." Symptoms can persist, and even worsen in the early days of refeeding, when a person remains weight-suppressed relative to their individual body's needs. A weight that looks normal on a population chart is not always the same as full weight restoration for that particular person.

Understanding this distinction can make a real difference in how families and clients approach recovery. We have put together a longer resource that walks through what the research says, why symptoms sometimes linger after treatment, and what questions are worth raising with an eating disorder-informed physician.