Health care professionals may now have a way to identify possible eating disorder cases a year before they would have been diagnosed, allowing patients to receive support much sooner, according to a new study.
Researchers analyzed provincial health data from Ontario, Canada, for people age 13 and older starting in 2008. The study team tracked participants’ electrolyte levels until 2020 and noted how many were diagnosed with eating disorders, according to the study published Tuesday in JAMA Network Open.
The results showed that people who experienced electrolyte abnormalities were twice as likely as those who didn’t to be diagnosed with an eating disorder — sometimes more than a year later. And people with severe abnormalities were more than five times as likely to be diagnosed, the study showed.
Abnormal electrolyte levels are common when a person is diagnosed with an eating disorder, said lead study author Dr. Gregory Hundemer, assistant professor of medicine at the University of Ottawa and a nephrologist at the Ottawa Hospital.
Eating disorder resources
US: National Eating Disorders Association
Electrolytes — important minerals such as potassium, phosphate and magnesium — can be thrown off by dehydration, restrictive diets, vomiting and use of laxatives, all of which may be symptomatic of an eating disorder, said Dr. Jason Nagata, assistant professor of pediatrics at the University of California, San Francisco. Nagata was not involved in this study.
Disordered eating patterns are often present well before a person is diagnosed, which is why the researchers hypothesized that electrolyte levels might be a good indicator of who might develop an eating disorder, Hundemer said.
“This study raised the concern that electrolyte abnormalities may be a red flag for more screening much earlier into the course of an eating disorder than we might think,” said Dr. Sydney Hartman-Munick, assistant professor of pediatrics at the University of Massachusetts Chan Medical School. Hartman-Munick was not involved in the study.
“We know that timely screening, diagnosis and treatment predict better prognosis for patients with eating disorders, and the study introduces the idea that electrolyte abnormalities may be a red flag that could lead to further evaluation, especially in the primary care setting,” Hartman-Munick added.
Early signs of eating disorders
Abnormal electrolyte levels can be life threatening, and eating disorders have risen since the pandemic started, Nagata said. From the spring of 2020 — when most Covid-19 restrictions/lockdowns were first put in place — through spring 2021, the number of eating disorder inpatient admissions in young adults and adolescents about doubled, according to a recent study.
This latest study on electrolyte abnormalities shows there is a potential for faster intervention, Hundemer said.
Diet culture and disordered eating
Many of the abnormalities were noted more than a year before diagnosis, and in that time, patients might be directed to more targeted screenings for eating disorders, he added.
“There is still so much we don’t know about the best methods for prevention and early detection for eating disorders, and this study offers new insight into future study in this area,” Hartman-Munick said.
Eating disorders are underrecognized and undertreated, especially among men, the LGBTQ community, people of color, older adults and those with larger bodies, Nagata said.
Health care providers should be aware of the risk that may come with abnormal electrolyte levels and the warning signs of an eating disorder — which include fasting, severe caloric restriction, vomiting, or using laxatives or diuretics to lose weight, he said.
If you are concerned about your weight loss behaviors — including vomiting, laxatives or diuretic use — you should talk with your health care provider about checking electrolyte levels, Nagata added.
Families of teens and adolescents who are showing signs of eating disorders should raise concerns with a health care provider, Nagata said. The professional can assess for an eating disorder and refer families to helpful resources, he added.
If you think someone you know might be struggling with an eating disorder, you can also call the National Eating Disorders Association helpline (800-931-2237) for guidance on how to provide support.
