We read with interest Roche and colleagues’ article1 demonstrating normalization of QT dynamicity and measures of heart rate variability (HRV) with refeeding in anorexia nervosa (AN).

ABSTRACT: Anorexia nervosa is a chronic eating disorder which often has a poor prognosis. The likelihood of success in treating this disorder, which most commonly strikes females in their prime of life, is greatly enhanced by the attainment of ideal body weight during the refeeding-weight restoration process.

ABSTRACT: Anorexia nervosa (AN) is associated with marked decreases in caloric intake and a corresponding reduction in body weight due to abnormal self-body image. Although counterintuitive, hypoalbuminemia and vitamin deficiencies are not expected consequences of this disorder. Etiologic considerations for hypoalbuminemia are discussed.

ABSTRACT: During the starvation phase of anorexia nervosa (AN), cardiac and skeletal muscle mass decreases, whereas electrocardiographic QT dispersion, a marker of arrhythmia risk, increases. QT dispersion during the chronic phase of AN and its relationship to resting metabolic rate (RMR) have not been described previously and is the subject of the current investigation. Six AN patients were compared with 10 age‐matched control subjects.

ABSTRACT: Refeeding syndrome (RS) is a rare but potentially fatal condition that can occur during refeeding of severely malnourished individuals (such as anorexia nervosa patients). After prolonged starvation, the body begins to use fat and protein to produce en

Heart rate variability was measured at rest and during ambulation in 6 women with anorexia nervosa. Compared with 10 nonanorexic women controls, resting and ambulatory measures of heart rate variability tended to be lower in patients, despite no differences in resting heart rate.

Read the full article in the American Journal of Cardiology.

Among psychiatric disorders, anorexia nervosa has the highest mortality rate. During an exacerbation of this illness, patients frequently present with nonspecific symptoms. Upon hospitalization, anorexia nervosa patients are often markedly bradycardic, which may be an adaptive response to progressive weight loss and negative energy balance. When anorexia nervosa patients manifest tachycardia, even heart rates in the 80–90 bpm range, a supervening acute illness should be suspected.

Bulimia nervosa is a common eating disorder that predominantly affects young women. There are three main models of purging in bulimia. Resulting medical complications are related to the particular mode and frequency of purging.

A 20-year-old woman presents with fatigue; laboratory tests reveal a serum potassium level of 2.3 mmol per liter and a serum bicarbonate level of 36 mmol per liter. She is 163 cm (64 in.) tall and weighs 54 kg (119 lb). The findings on physical examination are normal. On questioning, she admits to binge eating and vomiting as frequently as five times per day. How should she be treated?

Read the full article in the New England Journal of Medicine.