Body fat distribution before and after weight gain in anorexia nervosa.

Abstract

To study abdominal fat distribution in anorexia nervosa subjects and to assess the effects of initial weight regain on abdominal fat distribution. Longitudinal, clinical study. The baseline measurement was acquired within four days of admission to the eating disorders clinic. All patients were treated by re-feeding, reinforced by psychotherapy. Following weight regain of at least 5 kg, a second body fat distribution evaluation was performed. Of the 21 subjects evaluated at baseline, 14 achieved the goal of body weight regain and were retested. Fourteen subjects (age: 18-38 y; body mass index: 11.5-18.3; relative body weight: 54.9-88.3%). Total, subcutaneous and visceral abdominal adipose tissue areas at the L4-L5 level were evaluated by computed tomography. At baseline the subjects showed a higher proportion of visceral adipose tissue (% visceral adipose tissue = 55.3 +/- 26.1). A significant association was observed between body weight and both subcutaneous adipose tissue and total adipose tissue. A regain of body weight of 7.3 +/- 1.6 kg was accompanied by a significant increase in total adipose tissue, comprising both subcutaneous and visceral adipose tissue. The increase observed in subcutaneous adipose tissue, however, was significantly greater than for visceral adipose tissue (212.6% vs 116.8%, respectively, P < 0.01). The results of the current study show a higher proportion of visceral adipose tissue than subcutaneous adipose tissue in anorexia nervosa subjects. With regain of body weight there is a preferential regain of subcutaneous adipose tissue. These data demonstrate a redistribution of abdominal adipose tissue with weight regain in anorexia nervosa subjects.