Changes in Body Composition in Anorexia Nervosa: Predictors of Recovery and Treatment OutcomeReport as inadecuate

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The restoration of body composition BC parameters is considered to be one of the most important goals in the treatment of patients with anorexia nervosa AN. However, little is known about differences between AN diagnostic subtypes restricting AN-R and binge-purging AN-BP and weekly changes in BC during refeeding treatment. Therefore, the main objectives of our study were twofold: 1 to assess the changes in BC throughout nutritional treatment in an AN sample and 2 to analyze predictors of BC changes during treatment, as well as predictors of treatment outcome. The whole sample comprised 261 participants 118 adult females with AN 70 AN-R vs. 48 AN-BP, and 143 healthy controls. BC was measured weekly during 15 weeks of day-hospital treatment using bioelectrical impedance analysis BIA. Assessment measures also included the Eating Disorders Inventory-2, as well as a number of other clinical indices. Overall, the results showed that AN-R and AN-BP patients statistically differed in all BC measures at admission. However, no significant time×group interaction was found for almost all BC parameters. Significant time×group interactions were only found for basal metabolic rate p = .041 and body mass index BMI p = .035. Multiple regression models showed that the best predictors of pre-post changes in BC parameters namely fat-free mass, muscular mass, total body water and BMI were the baseline values of BC parameters. Stepwise predictive logistic regressions showed that only BMI and age were significantly associated with outcome, but not with the percentage of body fat. In conclusion, these data suggest that although AN patients tended to restore all BC parameters during nutritional treatment, only AN-BP patients obtained the same fat mass values as healthy controls. Put succinctly, the best predictors of changes in BC were baseline BC values, which did not, however, seem to influence treatment outcome.

Author: Zaida Agüera , Xandra Romero , Jon Arcelus, Isabel Sánchez, Nadine Riesco, Susana Jiménez-Murcia, Jana González-Gómez, Roser



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