Recurrent persistent hypophosphatemia in a male‐to‐female transgender patient with anorexia nervosa: Case report

Beaty, Larry A.; Mehler, Philip S.

doi:10.1002/eat.22707

Cited by 10 publications

(7 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most were case studies ( n = 18) detailing one to five individual cases of gender dysphoria, eating disorders, body image and dissatisfaction, and body size using a mix of qualitative and quantitative data. The findings from these case reports focused on transgender patients and their outcomes of gender affirming medical treatment [ 30 , 48 , 49 ], psychotherapy [ 50 – 52 ], psychiatric care [ 53 , 54 ], eating disorder treatment [ 55 – 59 ], nutrition assessments [ 33 ], some combination of treatments (e.g., gender affirming medical intervention and eating disorder treatment) [ 60 ], or diagnoses (e.g., autism spectrum disorder, gender dysphoria, and eating disorder) [ 61 ]. Three case reports included detailed patient medical records [ 61 , 62 ].…”

Section: Resultsmentioning

confidence: 99%

“…gender affirming hormone therapy, gender affirming surgery, etc.) [ 7 , 33 , 48 , 53 , 55 , 61 – 63 ], were diagnosed with gender dysphoria [ 7 , 49 , 50 , 53 , 54 , 56 – 58 , 60 , 61 ], had self-identified as transgender or gender non-binary/fluid [ 30 , 43 , 48 , 59 , 64 ], or some combination of these (e.g., self-identification and gender transition). One study used “biological” male or female to describe transgender participants and did not include the self-identification of the participants [ 62 ].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

A scoping review of research literature on eating and body image for transgender and nonbinary youth

Heiden-Rootes,

Linsenmeyer,

Levine

et al. 2023

J Eat Disord

View full text Add to dashboard Cite

Background Transgender and nonbinary (TGNB) adolescents and young adults are underrepresented in the literature on eating disorders and body image-related problems, despite increased mental health disparities and emerging research showing high associations between gender dysphoria, body image, and eating disorders among TGNB youth. Aims The scoping review was designed to critically examine the research on TGNB adolescents and young adults who experience eating and body image related problems as well as clinical studies on treatment approaches and effectiveness. Method Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used for reporting this scoping review. The electronic databases of MEDLINE and PsychInfo were used for searching subject terms. Inclusion criteria for studies required the quantitative measurement or qualitative exploration of body image or eating for transgender minor children, adolescents, or young adult samples (18 to 25 years old) and address differences in eating/body-related problems by age. The relevant data was extracted and narratively summarized. Results 49 studies were identified, data extracted, and analyzed. Increased prevalence of eating disorders and body image problems were identified for TGNB youth. Body-gender congruence through gender affirming social and medical interventions (e.g., hormone therapy) were noted as significant for alleviating body image problems and facilitating eating disorder treatment. Family and social factors were not well understood in the literature and a need for increased study of TGNB youth from varied racial/ethnic, neurodiverse, and within specific identities (e.g., nonbinary) and families and cultural contexts is still needed. Conclusions Future research should consider the use of developmental and family theories for guiding inclusion of salient social factors influencing eating patterns, body image, and treatment outcomes. In addition, more studies are needed with those from minoritized racial and ethnic groups, neurodiversity, and varied gender identities (e.g., nonbinary and gender queer) for identifying important differences.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A scoping review of research literature on eating and body image for transgender and nonbinary youth

Heiden-Rootes,

Linsenmeyer,

Levine

et al. 2023

J Eat Disord

View full text Add to dashboard Cite

show abstract

“…This sample did not represent transgender individuals who may require additional consideration in the context of hormonal treatment as seen in a recent case report of recurrent and persistent RH. 50…”

Section: Discussionmentioning

confidence: 99%

Vitamin D and Hypophosphatemia in Patients with Anorexia Nervosa and Avoidant/Restrictive Food Intake Disorder: A Case Control Study

Kells,

Roske,

Watters

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Refeeding hypophosphatemia (RH) is a common complication of nutritional restoration in malnourished individuals, yet clear risk stratification remains elusive. Individuals with anorexia nervosa (AN) and avoidant/restrictive food intake disorder (ARFID) may be deficient in vitamin D, an important component of dietary phosphorus absorption in the gut. The relationship between vitamin D and RH in AN and ARFID is unknown. Therefore, the aims of this of this study were to 1) describe the prevalence of low serum 25-hydroxy vitamin D levels and RH in AN and ARFID 2) report associations between nadir phosphorus level and variables associated with RH in extant literature and 3) examine the relationship between 25-hydroxy vitamin D levels and serum phosphorus nadir in AN and ARFID. Method Analyses included retrospective chart review of 307 individuals admitted to the ACUTE Center for Eating Disorders and Severe Malnutrition with a diagnosis of AN or ARFID. Variables of interest included admission laboratory values (vitamin D level, comprehensive metabolic panel, hemoglobin, point-of-care blood glucose), anthropometric measures (weight, body mass index [BMI], % ideal body weight [IBW]), age, duration of illness, length of stay, feeding method, and serum phosphorus nadir. Pearson and Spearman rank correlation, one-way ANOVA, and regression analyses were used to determine the relationship between variables and serum phosphorus. Results Over 1/3 of the sample (35.3%) had serum phosphorus levels ≤ 2.9 mg/dL. There were no significant differences between groups in phosphorus nadir (p = .17, η2 = 0.12) or hypophosphatemia (p = .16, ϕc = 0.11); 44% of individuals with ARFID and 33% of individuals with AN had hypophosphatemia. Nadir phosphorus showed a positive association with weight, BMI, %IBW, potassium, and calcium on admission, and a negative association with length of stay, hemoglobin, and total number of tube-fed days. Higher levels of 25-hydroxy vitamin D moderated the relationship between serum phosphorus nadir and weight on admission (p = .0004). Conclusion Individuals diagnosed with ARFID are as nutritionally fragile as those with AN regarding vitamin D and RH. The negative feedback loop involving vitamin D that maintains phosphorus homeostasis may play a role in the development of RH in AN and ARFID.

show abstract

“…For patients with restrictive eating disorders already taking GAHT, it may be prudent to measure levels more frequently, given the impact of restriction on the HPA axis. In addition, one case report describes persistent hypophosphatemia past the typical duration seen in refeeding syndrome in a trans woman taking spironolactone and estrogen [ 44 ]. Further research is needed to create an evidence base for best practices of hormone treatment during eating disorder treatment.…”

Section: Hormonal Treatmentsmentioning

confidence: 99%

Medical considerations in the care of transgender and gender diverse patients with eating disorders

Riddle

Safer²

2022

J Eat Disord

View full text Add to dashboard Cite

Transgender and gender diverse (TGD) individuals are at increased risk for the development of eating disorders, but very little has been published with regards to the unique aspects of their medical care in eating disorder treatment. Providing gender affirming care is a critical component of culturally competent eating disorder treatment. This includes knowledge of gender affirming medical and surgical interventions and how such interventions may be impacted by eating disordered behaviors, as well as the role of such interventions in eating disorder treatment and recovery. TGD individuals face barriers to care, and one of these can be provider knowledge. By better understanding these needs, clinicians can actively reduce barriers and ensure TGD individuals are provided with appropriate care. This review synthesizes the available literature regarding the medical care of TGD patients and those of patients with eating disorders and highlights areas for further research.

show abstract

Recurrent persistent hypophosphatemia in a male‐to‐female transgender patient with anorexia nervosa: Case report

Cited by 10 publications

References 18 publications

A scoping review of research literature on eating and body image for transgender and nonbinary youth

A scoping review of research literature on eating and body image for transgender and nonbinary youth

Vitamin D and Hypophosphatemia in Patients with Anorexia Nervosa and Avoidant/Restrictive Food Intake Disorder: A Case Control Study

Medical considerations in the care of transgender and gender diverse patients with eating disorders

Contact Info

Product

Resources

About