Electrolyte and other blood serum abnormalities in normal weight bulimia nervosa: Evidence for sampling bias

Abstract

Objective Sampling bias due to research settings might be responsible for reported high prevalence rates of electrolyte and serum abnormalities in bulimia nervosa. The aim of this study was to investigate the prevalence of electrolyte and other serum abnormalities in bulimia nervosa patients with normal weight seeking treatment in a community mental health center. Method Diagnostic evaluations and laboratory tests were done for a consecutive series of 31 patients meeting DSM‐III‐R criteria for bulimia nervosa. Results The duration and clinical severity of the eating disorder were considerable and psychiatric comorbidity was high. None of the subjects showed electrolyte abnormalities. Hypomagnesemia was found in 9.7% and hypoalbuminemia in 6.4% of the population. The severity of the abnormalities was modest. Discussion The results suggest that previous reports on electrolyte abnormalities in bulimia nervosa were affected by sampling bias. Based on the results, there is no indication to perform routinely laboratory studies in ambulatory patients with normal weight. © 2000 by John Wiley & Sons, Inc. Int J Eat Disord 27: 358–362, 2000.

The Psychology of Bulimia Nervosa

“…Mitchell et al 1983b). More recently, few and only minor (not clinically significant) abnormalities have been found (Peeters & Meijboom 2000). This may be due to differences in severity of patients-the latter study was conducted in a primary care rather than specialist setting.…”

Effect of weight‐regulating practices on potassium level in patients with anorexia or bulimia nervosa

“…The literature on potassium levels in such patients is comprehensive, yet confusing and sometimes contradictory. The proportion of bulimic patients with hypokalemia ranged in various studies from 0 to 18% (Mitchell, Pyle, Eckert, Hatsukami, & Lentz, 1983;Jacobs & Schneider, 1985;Mira, Stewart, Vizzard, & Abraham, 1987;Greenfeld, Mickley, Quinlan, & Roloff, 1995;Biebl & Kinzl, 1996;Crow, Salisbury, Crosby, & Mitchell, 1997;Peeters & Meijboom, 2000;Wolfe, Metzger, Levine, & Jimerson, 2001) and the proportion of patients with anorexia nervosa and hypokalemia from 0 to 100% (Wolff et al, 1968;Warren & Steinberg, 1979;Koh et al, 1989;Greenfeld et al, 1995;Biebl & Kinzl, 1996;Crow et al, 1997). Revisions made to various diagnostic systems also mean that the patient groups included in earlier studies are no longer really comparable to those in more recent ones.…”