Fluid Intake Among Patients with Eating Disorders

Reprinted from Eating Disorders Review
November/December 2005 Volume 16, Number 6
©2005 Gürze Books

Fluid intake and drinking behavior vary widely among patients with eating disorders, but few studies have specifically looked at this behavior. Some eating disorder patients may increase fluid intake in an attempt to weigh more and to depress hunger and appetite. Others may decrease fluid intake to avoid a feeling of fullness, abdominal discomfort and bloating, or to feel more in control.

A team at the University of Sydney, Australia, recently evaluated fluid intake among a group of eating disorders patients before the patients were admitted for inpatient treatment (Int J Eat Disord 2005;38:55). An experienced dietitian took a 7-day retrospective fluid intake history before patients were admitted. In face-to-face interviews, the dietitian prompted patients to recall and describe the frequency, type, and amounts of all fluids ingested during the past seven days.

Total fluid consumed each day was measured. This included all energy-free fluids (water, coffee with caffeine decaffeinated coffee, tea, herbal tea, and decaffeinated drinks, diet colas), energy-containing fluids (juice, milk-based products, including high-energy protein supplements, soft drinks, colas and soft drinks), and caffeine-containing fluids (colas, coffee, tea, and diet cola). Eighty-one patients participated in the study.

Fluid intake: from a very little to a lot

Fluid intake varied widely—from as little as 250 ml to 6925 ml (nearly 7 L)/day. Most patients reported drinking no alcoholic beverages during the week before being admitted for treatment, and only 1 reported excessive alcohol consumption, in this case 25 standard-sized drinks a day. Age was moderately correlated with fluid intake; that is, the older the patient, the greater the fluid intake. Also, older patients were more likely to drink energy-free drinks than were younger patients. Body weight did not correlate with any of the fluid intake variables.

The most popular drinks during the 7 days before admission were water, diet cola, coffee, juice, and tea. Diet cola was the soft drink of choice. Those who binge-ate or who induced vomiting had a significantly higher caffeine intake from diet cola, coffee and tea, but not a significantly higher overall fluid intake than thus who did not binge. Older patients and those with a lower body mass index drank more fluid than the other groups. It was unclear why these patients drank more than the other patients.

Among this sample, factors that affected the fluid intake of eating disorders patients included purging behavior and binge eating, which were associated with a higher intake of caffeinated beverages and excessive exercise. Age and body mass index did not predict total fluid intake. The Australian researchers state that fluid intake should be part of the clinical assessment of all eating disorder patients.

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