Electrolyte and other physiological abnormalities in patients with bulimia

Mitchell, James E.; Pyle, Richard L.; Eckert, Elke D.; Hatsukami, Dorothy K.; Lentz, Richard D.

doi:10.1017/s0033291700050881

Cited by 116 publications

(57 citation statements)

References 14 publications

(13 reference statements)

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“…Thus, our results might partly be explained by the fact that the subjects were of normal weight. An additional explanation is the fact that, although our population was engaged in self-induced vomiting, the frequency of this behavior was less than reported in some earlier studies (Mitchell et al, 1983;Jacobs & Schneider, 1985). Therefore, previous reports on the prevalence of electrolyte abnormalities in patients with BN might have been affected by sampling bias due to the higher severity of these clinical characteristics in patients seeking treatment in special care settings.…”

Section: Discussioncontrasting

confidence: 53%

“…Some studies (Pyle, Mitchell, & Eckert, 1981;Jacobs & Schneider 1985;Greenfeld et al, 1995) show modest prevalence rates of electrolyte and other serum abnormalities, whereas others report much higher rates (Mitchell, Pyle, Eckert, Hatsukami, & Lentz, 1983;Hall et al, 1989;Biebl & Kinzl, 1996). Serious blood serum abnormalities appear to be more prevalent among patients with low weight, frequent selfinduced vomiting, and laxative abuse.…”

Section: Introductionmentioning

confidence: 99%

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

Peeters

Meijboom

2000

Int. J. Eat. Disord.

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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.

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Section: Discussioncontrasting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

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

Peeters

Meijboom

2000

Int. J. Eat. Disord.

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“…In four studies the prevalence of laxative abuse among individuals with bulimia nervosa ranged from 38 to 63% [1][2][3][4], While laxatives reduce caloric absorption only by approxi mately 12% [5], patients with eating disorders often describe a sense of purging excess food. Indeed, the volume depletion and accompa nying nausea may cause them to feel unwell and diminish appetite.…”

Section: Introductionmentioning

confidence: 99%

Renal Failure Associated with Laxative Abuse

Copeland¹

1994

Psychother Psychosom

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Eating disorder patients often abuse laxatives in an attempt to purge excess food. Laxative abuse can cause hypokalemia and volume depletion. Hypokalemia, in turn, can lead to rhabdomyolysis. Laxative-induced hypokalemia and volume depletion have been previously reported to cause renal insufficiency, but not severe enough to require hemodialysis. A 27-year-old woman with a long history of laxative abuse presented with severe renal failure associated with hypokalemia and volume depletion. She required acute hemodialysis for worsening acidosis (pH 7.05) despite assisted ventilation. A prior episode of hypokalemic rhabdomyolysis at age 23 had resulted in only mild renal insufficiency. Her later episode of severe renal failure was linked to profound volume depletion (blood urea nitrogen 135 mg/dl). This patient calls attention to a potentially life-threatening complication of laxative abuse and indicates that volume depletion can exacerbate laxative-associated renal failure.

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“…The frequency of hypokalemia for patients in the current study is similar to the 5.5% rate reported by Greenfeld, Mickley, Quinlan, and Roloff (1995) in eating disorder outpatients. However, some studies have reported an absence of hypokalemia in bulimic patients (Peeters & Meijboom, 2000;Pyle, Mitchell, & Eckert, 1981) whereas others have observed hypokalemia in up to 55% of patients (Crow, Salisbury, Crosby, & Mitchell, 1997;Hall et al, 1989;Mira, Stewart, Vizzard, & Abraham, 1987;Mitchell et al, 1983Mitchell et al, , 1987Palla & Litt, 1988;Russell, 1979). Variability in results across studies is most likely to reflect changes over time in diagnostic nosology, wide differences in sample characteristics (e.g., body weight, symptom severity, method of purging), and the potential influence of psychiatric and medical comorbidity.…”

Section: Discussionmentioning

confidence: 99%