Adolescents with abnormal electrolytes measured as outpatients double their risk of being diagnosed with an eating disorder in the future, according to a study published in JAMA Network Open.¹

In this study, researchers analysed the association between electrolyte abnormalities measured as outpatients and eating disorders in residents of Ontario, Canada, aged 13 years or older from 2008 to 2020. They included 6970 individuals diagnosed with an incident eating disorder such as anorexia nervosa, bulimia nervosa and eating disorder not otherwise specified; they were matched with 27,878 age- and sex-matched individuals without an eating disorder as controls. Both groups had undergone electrolyte tests between 3 years and 30 days just prior to the diagnosis of an eating disorder.

Results showed that 18.4% of individuals with an eating disorder had a preceding electrolyte abnormality vs 7.5% of individuals without an eating disorder with adjusted odds ratio (aOR) of 2.12. The median time from the earliest electrolyte abnormality to eating disorder diagnosis was more than a year (386 days). The study also analysed the risk of eating disorders with specific electrolyte abnormalities. The aOR was 1.98 for hypokalemia, 5.26 for hyponatremia and 2.83 for hypophosphatemia. For hyperkalemia, the aOR was 1.97, for hypernatremia, it was 3.09 and for metabolic acidosis, the aOR was 2.60.

This study has demonstrated an association between abnormal electrolytes and eating disorders. It suggests that adolescents and adults with otherwise unexplained abnormal electrolytes should be screened for eating disorders.

Reference

1. Hundemer GL, et al. Analysis of electrolyte abnormalities in adolescents and adults and subsequent diagnosis of an eating disorder. JAMA Netw Open. 2022 Nov 1;5(11):e2240809. doi: 10.1001/jamanetworkopen.2022.40809.