Electrolyte and Acid-Base Abnormalities Associated with Purging Behaviors

International Journal of Eating Disorders
By Philip S. Mehler, MD, FACP, FAED, CEDS

Abstract

Objective: Eating disorders that are associated with purging behaviors are complicated by frequent blood electrolyte and acid-base abnormalities. Herein, we review the major electrolyte and acid-base abnormalities and their treatment methods. The body of rigorous, eating disorder-specific literature on this topical area is not robust enough to perform a systematic review as defined by PRISMA guidelines. Therefore, a qualitative review of mostly medical literature was conducted.

Results: Hypokalemia, hyponatremia, and sodium chloride-responsive metabolic alkalosis are the most common serum changes that occur as a result of purging behaviors. They vary depending on the mode and frequency of purging behaviors. They can all potentially cause dangerous medical complications and are in need of definitive medical treatment.

Discussion: Eating disorders that are associated with purging behaviors are associated with a number of electrolyte and acid-base changes which are complex in their origin, documented to be medically dangerous and this definitive treatment is necessary to help achieve a successful treatment outcome, and in need of definitive treatment as described herein.

Written by

Philip S. Mehler, MD, FACP, FAED, CEDS

Dr. Mehler founded ACUTE Center for Eating Disorders & Severe Malnutrition in 2001. He began his career at Denver Health more than 35 years ago and was formerly its Chief of Internal Medicine and…

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