Which electrolyte disturbance is commonly associated with purging in bulimia?

• A. Hypercalcemia
• B. Hypophosphatemia
• C. Hypoglycemia
• D. Hypokalemia

Answer: (D)

Purging in bulimia commonly causes loss of potassium through vomiting and laxative/diuretic use, which directly depletes serum potassium. Vomiting also results in loss of gastric acid, leading to metabolic alkalosis and hypochloremia; as the body tries to compensate for volume depletion, the kidneys increase potassium loss, worsening hypokalemia. This drop in potassium is the electrolyte disturbance most characteristically linked to purge behaviors and can lead to fatigue, muscle weakness, and potentially dangerous cardiac arrhythmias if severe. While other disturbances like hypercalcemia, hypophosphatemia, or hypoglycemia can occur in related contexts, they are not the hallmark association with purging in bulimia.