What is the role of zinc supplementation in patients with anorexia nervosa?

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Last updated: April 11, 2025View editorial policy

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From the Guidelines

Zinc supplementation is recommended for individuals with anorexia nervosa, typically at doses of 15-30 mg of elemental zinc daily, as it has been shown to improve weight gain outcomes and reduce depression symptoms in anorexia patients 1.

Key Considerations

  • Treatment should continue throughout the recovery process, often for several months.
  • Zinc gluconate, zinc acetate, or zinc sulfate are common formulations, with zinc gluconate often being preferred due to fewer gastrointestinal side effects.
  • Supplementation should be taken with food to minimize stomach upset, though not with dairy products or high-fiber foods which can reduce absorption.
  • Zinc deficiency is common in anorexia nervosa and can worsen symptoms including appetite loss, altered taste perception, and mood disturbances.
  • Zinc plays crucial roles in over 300 enzymatic reactions in the body, affecting appetite regulation, taste perception, immune function, and neurotransmitter activity.

Monitoring and Safety

  • While generally safe, excessive zinc can interfere with copper absorption, so long-term high-dose supplementation should be monitored by a healthcare provider as part of a comprehensive treatment plan for anorexia.
  • The American Psychiatric Association recommends a comprehensive treatment plan that incorporates medical, psychiatric, psychological, and nutritional expertise, commonly via a coordinated multidisciplinary team 1.

Treatment Goals

  • Individualized goals should be set for weekly weight gain and target weight for patients with anorexia nervosa who require nutritional rehabilitation and weight restoration 1.
  • Treatment should include normalizing eating and weight control behaviors, restoring weight, and addressing psychological aspects of the disorder, such as fear of weight gain and body image disturbance.

From the Research

Zinc Supplementation in Anorexia Nervosa

  • Zinc deficiency has been implicated in anorexia nervosa, and zinc supplementation has shown promise in treating the condition 2, 3, 4, 5.
  • Studies have demonstrated that zinc supplementation can increase the rate of weight gain and improve levels of anxiety and depression in anorexia nervosa patients 3, 4, 5.
  • The mechanism of action of zinc supplementation in anorexia nervosa is thought to involve the correction of abnormalities in neurotransmitters, such as gamma-amino butyric acid (GABA) and the amygdala, which are affected by low zinc intake 3.
  • Zinc supplementation has been shown to be safe and effective, with low toxicity, and should be considered as an adjunctive treatment for anorexia nervosa 3, 5.
  • The optimal dosage and duration of zinc supplementation in anorexia nervosa are not well established, but studies have used dosages ranging from 14 mg to 50 mg of elemental zinc per day 3, 4.
  • Micronutrient deficiencies, including zinc deficiency, are common in anorexia nervosa, and supplementation may be necessary to correct these deficiencies and support recovery 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Anorexia nervosa, zinc deficiency and the glutamate system: The ketamine option.

Progress in neuro-psychopharmacology & biological psychiatry, 2020

Research

How does zinc supplementation benefit anorexia nervosa?

Eating and weight disorders : EWD, 2006

Research

Zinc deficiency in anorexia nervosa.

Journal of adolescent health care : official publication of the Society for Adolescent Medicine, 1987

Research

Zinc supplementation in the treatment of anorexia nervosa.

Eating and weight disorders : EWD, 2002

Research

Micronutrient deficiencies and supplementation in anorexia and bulimia nervosa: a review of literature.

Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 2010

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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