Differences in serum zinc levels in acutely ill and remitted adolescents and young adults with bulimia nervosa in comparison with healthy controls – a cross-sectional pilot study

Abstract

BackgroundResearch has implicated that changes in zinc (Zn) metabolism may be associated with the biological underpinnings of eating disorders, in particular anorexia nervosa. However, to date research on the role of Zn in patients with bulimia nervosa (BN) is scarce.ObjectiveWe aimed to explore serum Zn concentrations in young patients with BN, with a focus on the stage of the disorder, comparing acutely ill and recovered patients with BN with healthy controls.MethodsSerum Zn concentrations were obtained from healthy controls and from acutely ill and remitted young patients with BN. Mean duration of remission was 4.0±3.5 years.ResultsRemitted patients showed elevated serum Zn concentrations when compared to controls (Cohen’s d=2.022), but concentrations were still in the normal range. Acutely ill patients also had higher serum Zn levels when compared to controls (all values still being within the reference range, Cohen’s d=0.882). There was no difference between acutely ill and remitted patients with BN in serum Zn concentrations. Of note, remitted patients had a significantly higher body weight when compared to the other two groups. Overall, there were no significant differences in dietary preferences with regard to Zn containing foods between the groups.ConclusionThe present study provides preliminary evidence that the underlying factors for changes in Zn serum concentrations in young patients with BN do not vary with regard to the stage of illness (acute versus remitted BN). Further prospective research is needed in order to disentangle the possible interplay between serum Zn status and bulimic eating behaviors.

Residual eating disorder symptoms and clinical features in remitted and recovered eating disorder patients: A systematic review with meta‐analysis

“…Remitted BN patients also showed altered serotonin (5-HT) function (Bailer et al, 2011;Pichika et al, 2012;Steiger et al, 2005), which is thought to interfere with mood and appetite regulation. Additionally, in remitted patients with BN, contrary to expectations of malnutrition and Zinc deficiency, higher serum zinc concentrations were reported compared to controls, possibly due to greater nutrient intake (Zepf et al, 2017).…”