Zinc levels in severe eating disorders

Abstract Purpose Severe eating and feeding disorders including Anorexia Nervosa of both restricting (AN-R) and binge-purge (AN-BP) subtypes and Avoidant Restrictive Food Intake Disorder (ARFID) lead to multiple macronutrient and micronutrient deficiencies, including zinc, in the setting of inadequat...

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Main Authors: Kara Leach, Dan V. Blalock, Judy Oakes, Melanie Hebert, Marina Foster, Philip S. Mehler
Format: Article
Language:English
Published: BMC 2025-02-01
Series:Journal of Eating Disorders
Subjects:
Online Access:https://doi.org/10.1186/s40337-025-01199-w
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author Kara Leach
Dan V. Blalock
Judy Oakes
Melanie Hebert
Marina Foster
Philip S. Mehler
author_facet Kara Leach
Dan V. Blalock
Judy Oakes
Melanie Hebert
Marina Foster
Philip S. Mehler
author_sort Kara Leach
collection DOAJ
description Abstract Purpose Severe eating and feeding disorders including Anorexia Nervosa of both restricting (AN-R) and binge-purge (AN-BP) subtypes and Avoidant Restrictive Food Intake Disorder (ARFID) lead to multiple macronutrient and micronutrient deficiencies, including zinc, in the setting of inadequate dietary intake. We investigated whether zinc levels correlated with severe malnutrition, with particular subtypes of eating disorders (EDs), and the effect of the refeeding process. Methods This prospective study included 92 adult patients with severe AN or ARFID hospitalized in a medical stabilization unit. Denver Health staff were recruited as controls. Blood samples were drawn within four days of admission and 72 h of discharge. All inferential analyses were performed using general linear models. Results Admission zinc levels were statistically significantly lower in cases compared to controls. Admission zinc levels were significantly higher for patients with AN-R than patients with AN-BP. Zinc levels decreased significantly during treatment in cases, compared to controls. ED diagnoses and percent ideal body weight (%IBW) did not appear to predict changes in zinc levels during admission. Conclusions Given zinc’s pervasive roles in metabolism throughout the body as well as common symptoms of deficiency including impaired taste and smell, decreased appetite, and depression, zinc levels could be relevant to the high relapse rate in severe ED. The observed decrease in zinc, which was larger in cases than controls, during refeeding suggests the possibility of a “refeeding hypozincemia” which may present a new therapeutic target. These characteristics make zinc an intriguing focus of future study that could impact the recidivism rate in severe ED. Level of evidence III Evidence obtained from well-designed cohort or case-control analytic studies.
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spelling doaj-art-7e5e2a5d99414e7baf3dd1ae7e40d3822025-02-09T12:04:06ZengBMCJournal of Eating Disorders2050-29742025-02-011311710.1186/s40337-025-01199-wZinc levels in severe eating disordersKara Leach0Dan V. Blalock1Judy Oakes2Melanie Hebert3Marina Foster4Philip S. Mehler5ACUTE Center for Eating Disorders and Severe Malnutrition at Denver HealthCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical CenterACUTE Center for Eating Disorders and Severe Malnutrition at Denver HealthACUTE Center for Eating Disorders and Severe Malnutrition at Denver HealthACUTE Center for Eating Disorders and Severe Malnutrition at Denver HealthACUTE Center for Eating Disorders and Severe Malnutrition at Denver HealthAbstract Purpose Severe eating and feeding disorders including Anorexia Nervosa of both restricting (AN-R) and binge-purge (AN-BP) subtypes and Avoidant Restrictive Food Intake Disorder (ARFID) lead to multiple macronutrient and micronutrient deficiencies, including zinc, in the setting of inadequate dietary intake. We investigated whether zinc levels correlated with severe malnutrition, with particular subtypes of eating disorders (EDs), and the effect of the refeeding process. Methods This prospective study included 92 adult patients with severe AN or ARFID hospitalized in a medical stabilization unit. Denver Health staff were recruited as controls. Blood samples were drawn within four days of admission and 72 h of discharge. All inferential analyses were performed using general linear models. Results Admission zinc levels were statistically significantly lower in cases compared to controls. Admission zinc levels were significantly higher for patients with AN-R than patients with AN-BP. Zinc levels decreased significantly during treatment in cases, compared to controls. ED diagnoses and percent ideal body weight (%IBW) did not appear to predict changes in zinc levels during admission. Conclusions Given zinc’s pervasive roles in metabolism throughout the body as well as common symptoms of deficiency including impaired taste and smell, decreased appetite, and depression, zinc levels could be relevant to the high relapse rate in severe ED. The observed decrease in zinc, which was larger in cases than controls, during refeeding suggests the possibility of a “refeeding hypozincemia” which may present a new therapeutic target. These characteristics make zinc an intriguing focus of future study that could impact the recidivism rate in severe ED. Level of evidence III Evidence obtained from well-designed cohort or case-control analytic studies.https://doi.org/10.1186/s40337-025-01199-wZincSevere eating disorderAnorexia nervosaARFIDMalnutrition
spellingShingle Kara Leach
Dan V. Blalock
Judy Oakes
Melanie Hebert
Marina Foster
Philip S. Mehler
Zinc levels in severe eating disorders
Journal of Eating Disorders
Zinc
Severe eating disorder
Anorexia nervosa
ARFID
Malnutrition
title Zinc levels in severe eating disorders
title_full Zinc levels in severe eating disorders
title_fullStr Zinc levels in severe eating disorders
title_full_unstemmed Zinc levels in severe eating disorders
title_short Zinc levels in severe eating disorders
title_sort zinc levels in severe eating disorders
topic Zinc
Severe eating disorder
Anorexia nervosa
ARFID
Malnutrition
url https://doi.org/10.1186/s40337-025-01199-w
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AT danvblalock zinclevelsinsevereeatingdisorders
AT judyoakes zinclevelsinsevereeatingdisorders
AT melaniehebert zinclevelsinsevereeatingdisorders
AT marinafoster zinclevelsinsevereeatingdisorders
AT philipsmehler zinclevelsinsevereeatingdisorders