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A patient presented with severe hypophosphataemia that had been precipitated during binge eating. It was corrected by restricting the binges, and by hyperalimentation through a duodenal tube together with intravenous supplementation with sodium phosphate for a short period. Phosphate concentrations should be monitored in patients with severe anorexia complicated by bulimic episodes.A low serum phosphate concentration is a complication that has been recorded in several conditions, including hyperalimentation by intravenous fluids deficient in phosphate,' 2 alcohol withdrawal, diabetic ketoacidosis, recovery after extensive burns, and refeeding of malnourished prisoners of war. In anorexic patients hypophosphataemia has been noted during both intravenous hyperalimentation and oral refeeding (when the patients were starved but using laxatives). (see table). Urinalysis gave normal results.

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