Abstract

In the general population, body weight is-on average-higher in the winter than in the summer. In patients with anorexia nervosa (AN), however, the opposite pattern has been reported. Yet, only a handful of studies exist to date that suffer from small sample sizes and inconsistent results. Therefore, the current study examined seasonal effects on body weight in a large sample of patients with AN to dissolve previous inconsistencies. Clinical records of N = 606 inpatients (95.4% female) who received AN treatment at the Schoen Clinic Roseneck (Prien am Chiemsee, Germany) between 2014 and 2019 were analyzed. Patients with restrictive type AN had lower body mass index at admission in the winter than in the summer. This difference was not found for patients with binge/purge type AN and patients with atypical AN. Individuals with restrictive type AN show seasonal variations in body weight that are opposite to seasonal variations in body weight in individuals without AN. These seasonal effects are specific to the restrictive subtype and cannot be found for the binge/purge or atypical subtypes. Future studies that replicate this effect in other cultures or latitudes and that examine the mediating mechanisms are needed.

Highlights

  • Seasonal variations in body weight have been consistently reported

  • The majority of patients were diagnosed as restrictive type anorexia nervosa (AN) (F50.00; 61.6%); 22.4% were diagnosed as binge/purge type AN (F50.01); and 16.0% were diagnosed as atypical AN (F50.1; Table 1), according to the German version of the International Classification of Diseases (ICD-10-GM, https:// www.dimdi.de/static/de/klassifikationen/icd/icd-10-gm/kode-suche/ htmlgm2020/block-f50-f59.htm)

  • The current study reports the largest sample of patients with AN to date in which seasonal variations in body mass index (BMI) at admission were examined as a function of AN subtypes

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Summary

Introduction

In European and North American countries, body mass index (BMI) is on average higher in the winter than in the summer (Mehrang, Helander, Chieh, & Korhonen, 2016) This pattern has been found both in the general population (Visscher & Seidell, 2004) and in overweight adults participating in a behavioral weight loss intervention (Fahey, Klesges, Kocak, Talcott, & Krukowski, in press). In a study from Germany, Born et al (2015) found that BMI at admission during autumn and winter was lower in adult inpatients with restrictive AN than in binge/purge type AN, whereas subtypes did not differ in BMI during spring and summer.

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