Electrolytes and Eating Disorders

Claudine was a 20 year old former administrative assistant, who gave a 4 year history of purging anorexia nervosa. She attended the eating disorders outpatient clinic following an Emergency presentation and 2 days in the Short Stay Unit for suicidal ideation. She was accompanied by her mother who was herself almost certainly suffering from exercise anorexia nervosa and who complained that her daughter had stolen large amounts of money from her. Claudine denied binge eating but admitted to inducing vomiting after any oral intake and insisted that her general practitioner was monitoring her weekly and prescribing potassium supplements 4–6 tablets a day (2400–3600 mg, i.e., 32–48 mmol K+/day) which she was taking. Her BMI was 16.8. Her serum K+ was 3.1 mmol/L and her bicarbonate level was 36 mmol/L. Chloride level was 96 mmol/L and other parameters were normal including amylase which was 118 mmol/L. She was admitted to a specialized eating disorders program where her ECG was normal and...