A significant study published in The Lancet Psychiatry reveals that 32% of individuals with eating disorders exhibit abnormal electrolyte levels, which are associated with an increased risk of death from any cause. Conducted by researchers at the Institute for Clinical Evaluative Sciences (ICES) and The Ottawa Hospital, this research highlights a critical risk factor for mortality and adverse health outcomes in this vulnerable population.
Electrolyte imbalances, which can arise from behaviors such as purging, laxative use, and dehydration, disrupt essential bodily functions. The study found that these abnormalities are also linked to severe health issues, including chronic kidney disease, bone fractures, bowel obstructions, and acute kidney injury.
“This study underscores the need to explicitly consider electrolyte abnormalities when assessing the severity of eating disorders,” said Dr. Marco Solmi, the lead author and Medical Director of the Regional Eating Disorder Program at The Ottawa Hospital.
The research analyzed health records from over 6,000 individuals aged 13 and older diagnosed with an eating disorder, all of whom underwent electrolyte level testing within a year of their diagnosis. The data was collected from hospitalization and emergency department records across Ontario, Canada, between 2008 and 2019.
Among the participants, the most common diagnosis was an eating disorder not otherwise specified (59%), followed by anorexia nervosa (22%) and bulimia nervosa (15%). The average age of participants was 27, with 89% identifying as female. Of the individuals with electrolyte abnormalities, 1,987 (32%) were identified, and many suffered from additional health conditions.
The findings revealed a stark contrast in mortality rates: 16% of individuals with electrolyte disorders died, compared to just 6% among those without such abnormalities. Furthermore, electrolyte imbalances were correlated with a heightened risk of hospitalization and other serious health conditions, although they were not linked to an increased risk of infection or heart disease events.
“These findings emphasize the necessity of routine electrolyte testing for individuals with eating disorders and the importance of addressing any abnormalities to potentially mitigate the risk of death and severe health outcomes,” stated Dr. Nicholas Fabiano, a psychiatry resident and co-lead author of the study.
The study also highlights the need for improved patient education and awareness. “Patients with eating disorders often deny their condition or fail to recognize the serious health implications,” noted Dr. Gregory Hundemer, senior author of the study and an adjunct scientist at ICES. “Our research demonstrates that severe eating disorders leading to electrolyte disturbances can have significant long-term health consequences.”
The researchers suggest that their findings could reshape clinical approaches to assessing the severity of eating disorders, which currently rely heavily on body mass index (BMI) and the frequency of specific behaviors like binge eating. Recognizing electrolyte abnormalities may aid in identifying patients who do not fit conventional eating disorder profiles, ultimately enhancing care and reducing the risk of mortality and other adverse outcomes.
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