Effect of early or late nutritional intervention with psychological support on symptoms associated with Anorexia Nervosa: a comparative study

Abstract

Introduction: Anorexia nervosa (AN) is a disease with increasing incidence and prevalence, favored by biological, psychological, familial, and social factors. Management must be interdisciplinary, involving the intervention of nutritionists and psychologists. Additionally, it is important to evaluate the effect of an early or a late onset of the intervention. Objective: To determine if early nutrition-based intervention along with psychological support leads to a decrease in the symptoms associated with Anorexia Nervosa, when compared with late intervention. Methods: To evaluate the above parameters, an exploratory study was proposed with a design of non-randomized clinical trial and a non-probability purposive sampling of n = 17 women with AN between 12 and 25 years of age (x̄ = 16.8 ± 3.6). According to the moment of the nutritional intervention with psychological support, the 17 women were divided into two groups: Group 1 (n = 10) start the intervention in the first six months after the onset of the disease while Group 2 (n = 7) started 3 years after the disease. The nutritional and psychological carried out consisted of three phases: individualized nutritional assessment, design of the meal plan according to the metabolic needs of each patient and nutritional indications, and an individualized psychological intervention. Both interventions were carried out once a week for six months, for a total of 24 psychological and nutritional sessions. The physical variables of body mass index (BMI) and arm muscle area (AMA) were measured. To assess emotional changes, the body image dissatisfaction subscale of the Eating Disorder Inventory (EDI) was used. Results: Six months after follow-up, the results showed statistically significant changes in the BMI (p <,0.01), AMA (p <,0.01) and body image dissatisfaction (p <,0.01) after the intervention. It was found that the early-intervention group presented lower values in BMI and AMA as compared to the late-intervention patients while both groups showed a marked reduction in body image dissatisfaction values. The late-intervention group presented the sharpest reduction. There was no significant difference in the variables BMI and AMA in the intragroup comparisons. Conclusion: The early-onset nutritional intervention with psychological support decreased the physical and emotional symptoms associated with AN.