Abstract
Weight restoration is considered a principal outcome for treatment of Anorexia Nervosa (AN) due to the significant physiological disturbances resultant from acute states of malnutrition. Treatment outcomes for populations with AN are relatively poor, with increasing evidence suggesting that weight restoration alone is insufficient for long-term recovery. Research aimed at understanding the psychological sequaele of AN, in particular during weight restoration, nevertheless remain scarce. This systematic review aimed to evaluate existing research regarding anxiety symptoms during treatment for AN, and the relationship of anxiety symptomology and weight restoration. Twelve articles were identified from a systematic search of three electronic databases (PsycINFO, MEDLINE, and Web of Science), and were eligible for inclusion. Study methodology, results and quality were reviewed. Results regarding change in anxiety symptomology were inconsistent, though evidence did not support a relationship between anxiety change and weight restoration. Reasons for these inconsistencies and limitations of included studies were reviewed. Further research is warranted to elucidate the role of anxiety in AN and its implications for treatment and longer-term outcome.
Highlights
Weight restoration is considered a principal outcome for treatment of Anorexia Nervosa (AN) due to the significant physiological disturbances resultant from acute states of malnutrition
Zerwas et al [39] found that trait anxiety was a negative prognostic factor independently associated with AN recovery, and Thornton et al [40] found that individuals with comorbid AN and Generalised Anxiety Disorder (GAD) diagnoses attained significantly lower BMI’s than individuals with AN only
This review aims to clarify the expression of anxiety symptoms during treatment, and to determine the nature of the relationship between anxiety and weight normalization in AN patients
Summary
Weight restoration is considered a principal outcome for treatment of Anorexia Nervosa (AN) due to the significant physiological disturbances resultant from acute states of malnutrition. Treatment outcomes for populations with AN are relatively poor, with increasing evidence suggesting that weight restoration alone is insufficient for long-term recovery. This systematic review aimed to evaluate existing research regarding anxiety symptoms during treatment for AN, and the relationship of anxiety symptomology and weight restoration. Results regarding change in anxiety symptomology were inconsistent, though evidence did not support a relationship between anxiety change and weight restoration Reasons for these inconsistencies and limitations of included studies were reviewed. There have been some theoretical suggestions that depressive symptomology in AN results in response to prolonged illness and symptom chronicity [30], whereas anxiety symptomology may increase vulnerability to eating disorder pathology [31]. Despite increasing evidence documenting the functional interplay between AN and anxiety, and suggestions pointing to the utility of understanding anxiety symptomology for efficacious treatment of AN [41], research remains limited
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