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Hyperphosphatemia: an objective marker for bulimia nervosa?

O B Bonne1, E Gur, E M Berry

  • 1Department of Psychiatry, Hadassah University Hospital, Jerusalem, Israel.

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Summary

Elevated serum phosphorus levels may indicate bulimia nervosa, a finding often overlooked in eating disorder research. This biochemical marker could aid in diagnosing bulimia nervosa, especially when other signs are subtle.

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Area of Science:

  • Clinical Biochemistry
  • Psychiatry
  • Eating Disorders

Background:

  • Phosphorus abnormalities are infrequently studied in eating disorders.
  • Existing research often links bulimia nervosa and anorexia nervosa to decreased phosphorus levels.
  • Recent observations suggest hyperphosphatemia in some hospitalized bulimic patients with normal renal function and calcium.

Purpose of the Study:

  • To investigate the prevalence of hyperphosphatemia in female patients with bulimia nervosa.
  • To compare serum phosphorus levels between bulimic patients and healthy controls.
  • To assess if elevated phosphorus levels can serve as a diagnostic marker for bulimia nervosa.

Main Methods:

  • Retrospective review of case files for 30 inpatient/outpatient female bulimic patients.
  • Comparison with 30 sex- and age-matched healthy psychiatric inpatients/outpatients.
  • Analysis of serum phosphorus and related electrolytes.

Main Results:

  • 80% (24/30) of bulimic patients exhibited at least one elevated serum phosphorus concentration.
  • Elevated phosphorus levels were typically mild to moderate.
  • No significant correlation was found between phosphorus levels and other electrolytes, binge-purge frequency, or laxative use.

Conclusions:

  • Elevated serum phosphorus levels are common in patients with bulimia nervosa.
  • Hyperphosphatemia may represent an objective biochemical marker for bulimia nervosa.
  • This finding could aid in the diagnosis of bulimia nervosa, which is often delayed due to normal weight and denial of symptoms.