Abstract
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.
Highlights
Body composition (BC) is considered an accurate measurement of nutritional status and health risk [1,2]
The Food and Agriculture Organization of the United Nations (FAO) have reported that, among the general population of women, 20–30% of the total body weight consists of fat mass (FM) [4], and the total body water (TBW) in healthy adult women accounts for 45%–60% of total body weight [5]
The first main finding of the present study was that both Anorexia nervosa (AN)-R and AN-BP patients showed altered BC compared to healthy controls, which is consistent with the findings of other authors [7,10,11,14]
Summary
Body composition (BC) is considered an accurate measurement of nutritional status and health risk [1,2]. Because of low weight levels, it is not surprising that patients with AN have been found to exhibit multiple metabolic disturbances and a significant decrease in FM and FFM [7], as well as high levels of TBW [8] Both NICE and APA treatment guidelines consider the recovery of body weight and the restoration of BC to be one of the most important goals in the treatment of patients with AN, little research has been carried out in this area. Some studies have shown that adult female patients with AN present a disproportionate increase of trunk fat after weight gain, resulting in central adiposity [13,14,15] It seems that this abnormal fat distribution normalizes with time as long as weight recovery is maintained [16]. Patients with AN may experience higher basal metabolic rate (BMR) during refeeding treatment and usually need to eat more calories than healthy individuals to maintain the same healthy weight [18]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
