Publication:
Changes in Body Composition in Anorexia Nervosa: Predictors of Recovery and Treatment Outcome.

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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.
Description
Journal Article; Research Support, Non-U.S. Gov't;
MeSH Terms
Medical Subject Headings::Psychiatry and Psychology::Mental Disorders::Eating Disorders::Anorexia Nervosa
Medical Subject Headings::Anatomy::Tissues::Connective Tissue::Adipose Tissue
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Techniques, Endocrine::Thyroid Function Tests::Basal Metabolism
Medical Subject Headings::Psychiatry and Psychology::Mental Disorders::Eating Disorders::Binge-Eating Disorder
Medical Subject Headings::Phenomena and Processes::Chemical Phenomena::Biochemical Phenomena::Body Composition
Medical Subject Headings::Phenomena and Processes::Physiological Phenomena::Body Constitution::Body Weights and Measures::Body Mass Index
Medical Subject Headings::Anatomy::Fluids and Secretions::Body Fluids::Body Water
Medical Subject Headings::Phenomena and Processes::Physical Phenomena::Magnetic Phenomena::Electromagnetic Phenomena::Electricity::Electric Conductivity::Electric Impedance
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Psychiatry and Psychology::Behavior and Behavior Mechanisms::Motivation::Goals
Medical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Statistics as Topic::Models, Statistical::Logistic Models
Medical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Outcome and Process Assessment (Health Care)::Outcome Assessment (Health Care)::Treatment Outcome
DeCS Terms
CIE Terms
Keywords
Anorexia nerviosa, Tejido adiposo, Metabolismo basal, Trastorno por atracón, Composición corporal, Índice de masa corporal, Agua corporal, Impedancia eléctrica, Metas, Humanos, Femenino, Modelos logísticos, Resultado del tratamiento
Citation
Agüera Z, Romero X, Arcelus J, Sánchez I, Riesco N, Jiménez-Murcia S, et al. Changes in Body Composition in Anorexia Nervosa: Predictors of Recovery and Treatment Outcome. PLoS ONE; 10(11):e0143012