Q & A: Patient Who Overuses Salt

Q: I’ve recently encountered a patient with anorexia nervosa binge-eating, purging type who also cuts compulsively, and who puts large quantities of salt on her food. I’ve seen other types of unusual food and spice habits, but this pattern was new to me. Has this phenomenon been studied? (B.B., Charlottesville, NC)

A: It’s not uncommon for patients with anorexia nervosa to show bizarre taste preferences and to habitually spice their foods in unusual ways. Some authorities theorize that such bizarre taste preferences may partly result from zinc deficiency, since zinc is known to be very important for the normal functioning of taste buds. Some patients are thought to highly salt their foods in an effort to retain water prior to being weighed in during nutritional rehabilitation programs. A specific pattern of salt ingestion, called “salinophagia,” has also been described by Morgan and Lacey. The authors interpret this pattern as a possible form of self-punishment, which might be consistent with the cutting pattern you’ve seen (IJED. 2010; 43:190). If the patient’s renal function is compromised, excessive salt ingestion could lead to significant medical risk, but normal kidneys usually do a reasonably good job of excreting excessive dietary salt.

— JY