How Calorie-Restrictive Eating Disorders Can Lead to an Underactive Thyroid

Thrive • January 2, 2022

By Thrive Reno’s Director of Primary Care Services Becky Barnett, PA-C

The Vital Role of the Thyroid in Your Health

The butterfly-shaped thyroid gland, located at the base of the throat, plays a crucial role in the body's endocrine system. Though small, this gland is responsible for regulating vital body functions by releasing hormones that impact nearly every cell, organ, and function within the body. The thyroid’s hormones are especially critical in managing metabolism, growth, and development, making it a powerhouse despite its size.

The Impact of Malnutrition on Thyroid Function

When a person experiences a calorie-restrictive eating disorder, such as anorexia nervosa, the body's response is to slow down thyroid function. This is a survival mechanism; the thyroid reduces the production and secretion of hormones to conserve energy in response to the lack of nourishment. However, this adaptive response can lead to significant health issues. Severe starvation can cause the thyroid gland to atrophy, or shrink, further weakening its function.

Recognizing the Symptoms of an Underactive Thyroid

Hypothyroidism, or low levels of thyroid hormones, can have wide-reaching effects on the body, particularly on metabolic processes. Below are some of the critical symptoms to be aware of:


Slowed Heart Rate: The lack of thyroid hormones can weaken the heart's ability to pump effectively, leading to a slower heart rate.


Elevated Cholesterol Levels: With a sluggish thyroid, the liver processes blood more slowly, potentially causing cholesterol to accumulate in the arteries.

 

Decreased Metabolic Rate: Low thyroid hormone levels can reduce the body's ability to convert food and drink into energy.

 

Lower Body Temperature: A slowed metabolism may result in a drop in core body temperature, often causing an individual to feel constantly cold.

 

Digestive Issues: Reduced metabolism can lead to constipation and other digestive problems.

 

Muscle Pain and Weakness: Insufficient thyroid hormones can cause muscles to feel weak, achy, and prone to cramping.

 

Cognitive Impairments: Hypothyroidism can manifest as "brain fog," characterized by forgetfulness, confusion, delayed reaction times, and difficulty concentrating.

 

Mood and Mental Health Symptoms: The overlap between hypothyroidism and depression symptoms is significant, with fatigue, social withdrawal, apathy, anxiety, and irritability being common in both conditions.

 

Given the overlap between the symptoms of hypothyroidism and eating disorders, it’s essential to have blood tests done to accurately diagnose low thyroid hormone levels.

Restoring Thyroid Health Through Recovery

The good news is that individuals in recovery from eating disorders can often restore healthy thyroid function. By gradually increasing caloric intake and working towards restoring a healthy body weight, the thyroid typically begins to normalize, as do many other bodily functions.

Thrive’s Comprehensive Eating Disorder Treatment

At Thrive, we understand the complex relationship between physical health and mental well-being. Our integrated approach to eating disorder treatment addresses the full spectrum of health—physical, mental, and emotional. Our expert-led team is here to help you on your recovery journey. Reach out to us to learn more about how we can support you in healing and reclaiming your life.

About the Author

Becky Barnett, PA-C — Thrive Reno Director of Primary Care Services

Becky Barnett, PA-C, has worked as a Physician Assistant for over 25 years with a primary focus on women’s health. She earned a bachelor’s degree from U.C. Riverside in 1991, and graduated from the College of Osteopathic Medicine of the Pacific (now Western University of Health Sciences) as a Physician Assistant in 1995. She has worked in various venues including community health centers, residential mental health facilities, large HMO settings and private practices as she moved throughout California and then into Nevada in 2001. She is proud to represent the medical team of Thrive Wellness of Reno, and is thrilled to be a part of such an authentic and passionate group.

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August 21, 2025
When Emma was 8, her parents noticed her food choices shrinking. At first, they assumed it was just picky eating — “She’ll outgrow it,” friends said. But by 10, Emma would only eat crackers, cheese, and chicken nuggets. Family dinners became nightly struggles, her growth slowed, and she skipped birthday parties to avoid “strange food.” Her parents felt powerless, her brother grew frustrated, and outings dwindled. What began as food avoidance soon reshaped the rhythm of the entire household. When children avoid food, most parents expect it’s a passing stage. But when restriction deepens, shrinks to only a few “safe foods,” and begins affecting growth or health, families suddenly find themselves in unfamiliar territory. This is often where Avoidant/Restrictive Food Intake Disorder (ARFID) emerges — with effects that extend far beyond the plate. As providers, we need to be attuned to these patterns. It’s tempting to dismiss them as “no big deal,” yet for many families, they are life-altering. Sadly, Emma’s story is not unusual. Mealtimes as Battlegrounds Families living with ARFID often describe mealtimes as emotionally charged, exhausting, and unpredictable. What should be a chance to connect around the table can feel more like a negotiation or even a standoff. Parents wrestle with whether to push their child to try a new food or give in to the same “safe foods” again and again to avoid tears, gagging, or complete meltdowns. This ongoing tension can make mealtimes dreaded rather than cherished. Siblings, too, are affected. Some may feel resentful when family meals are limited to what only one child will tolerate. Others may act out in response to the constant attention the child with ARFID receives. Over time, the dinner table shifts from a place of nourishment and bonding into a stage for conflict, anxiety, and guilt — a pattern that can erode family cohesion and resilience. Social Isolation and Missed Experiences ARFID impacts more than what happens at home; it influences how families engage with the world around them. Everyday events — birthday parties, school lunches, vacations, even extended family dinners — become sources of stress. Parents may pack special foods to avoid confrontation or, in many cases, decline invitations altogether to protect their child from embarrassment or overwhelm. This avoidance can lead to an unintended consequence: isolation. Families miss out on milestones, friendships, and traditions because of the unpredictability surrounding food. The child may feel left out or ashamed, while parents grieve the loss of “normal” family experiences. This social withdrawal can compound the anxiety already present in ARFID and deepen its impact across generations. Emotional Toll on Parents The emotional strain on parents navigating ARFID is significant. Many describe living in a constant state of worry — Will my child get enough nutrients? Will they ever grow out of this? Am I doing something wrong? This worry often spirals into guilt and self-blame, particularly when outside voices dismiss the disorder as mere “picky eating.” In addition, the pressure to “fix” mealtimes can strain marital relationships, creating disagreements over discipline, feeding strategies, or medical decisions. Parents may also feel emotionally depleted, pouring all their energy into managing one child’s needs while inadvertently neglecting themselves or their other children. Without support, this chronic stress can lead to burnout, depression, and disconnection within the family system. The Role of Providers For clinicians, ARFID must be viewed not only as an individual diagnosis but as a family-wide challenge. Effective care requires attention to both the clinical symptoms and the family dynamics that shape recovery. Parent Support: Educating caregivers that ARFID is not their fault, offering psychoeducation, and helping them reframe mealtime struggles as part of the disorder — not a parenting failure. Family-Based Interventions: Coaching families in structured meal support, communication strategies, and gradual exposure work so parents don’t feel powerless. Holistic Care: Involving therapists, dietitians, occupational therapists, and medical providers ensures that the family does not shoulder the weight of treatment alone. When families are validated, supported, and given practical tools, the entire household can begin to heal. Treatment is not only about expanding a child’s food repertoire but also about restoring peace, resilience, and connection at home. Moving Forward ARFID may begin with one individual, but its ripple effects are felt across the entire family system. By addressing both the psychological and relational dimensions, providers can help transform mealtimes from a source of conflict into an opportunity for healing and connection. For those who want to go deeper, we invite you to join our upcoming training on ARFID , where we will explore practical strategies for supporting both clients and their families.
July 30, 2025
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As a parent, noticing alarming behaviors around food or routines in your child can raise some important questions. You might be asking yourself, “Is this an eating disorder, obsessive-compulsive disorder (OCD), or something else entirely?” Understanding the signs and differences between these disorders is key to getting your child effective, timely treatment. In this blog, we’ll break down the overlap between OCD and eating disorders, what signs to watch for, and how to get professional help. If you're a parent wondering “Is my child’s eating disorder actually OCD?” or “OCD vs eating disorder in teens,” know that you’re not alone and you’re in the right place to find specialized care for your child. What Is OCD? Obsessive-Compulsive Disorder (OCD) is a mental health condition where unwanted thoughts (obsessions) cause anxiety, leading to repetitive behaviors (compulsions) intended to ease that anxiety. OCD can be focused on any subject. Common obsessions include contamination, perfectionism, scrupulosity, and harm, but sometimes, the content of obsessions can be focused on food, body image, or weight. What Is an Eating Disorder? Eating disorders , like anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant/restrictive food intake disorder (ARFID) involve disturbed eating behaviors and intense concerns about body weight or shape. These conditions go beyond dieting or “picky eating” and can become life-threatening without professional intervention. The Overlap: Why It Can Be Confusing OCD and eating disorders often share similar symptoms : Ritualistic eating (e.g., needing to eat foods in a certain order or at a certain time) Rigid rules about food (like only eating certain food groups or certain amounts of food) Excessive checking (like weighing food or body or repeated checking of expiration dates or thorough cooking) Avoidance behaviors ( like avoiding carbs, fats, or other food groups or avoiding places or objects that can trigger obsessions) Distress when routines are disrupted (either around mealtimes or exercise routines) So, How Can You Tell the Difference? Use the following chart to compare and contrast symptoms of OCD and eating disorders.
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