Body composition in female anorexia nervosa patients

Probst, Michel; Goris, Marina; Vandereycken, Walter; Coppenolle, H Van

doi:10.1079/bjn19960072

Cited by 53 publications

(38 citation statements)

References 52 publications

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“…Striking changes in body composition can be observed in patients with anorexia nervosa: for instance, in our study the initial body weight corresponded on average to 73% of controls' value while (according to DXA) FFM and FM were reduced by 17 and 71%, respectively. This is in agreement with previous papers which have indicated that in this case the reduction in body mass involves both adipose and lean tissues, but the former to a greater extent (Fohlin, 1977;Davies et al, 1978;Forbes et al, 1984;Probst et al, 1996;Orphanidou et al, 1997;Polito et al, 1998).…”

Section: Discussionsupporting

confidence: 82%

“…Several investigators have evaluated body composition in anorectic patients (Fohlin, 1977;Hannan et al, 1990;Krahn et al, 1993;Scalfi et al, 1993;Nuñiez et al, 1994;Probst et al, 1996;Orphanidou et al, 1997;Polito et al, 1998): a decrease of both fat-free mass (FFM) and fat mass (FM) has always been reported, with lean tissues accounting for a variable percentage of the reduction in body mass. With respect to refed patients, changes in FFM and FM (Orphanidou et al, 1997;Probst et al, 2001), body potassium (Pirke et al, 1986), total body water and its intracellular=extracellular distribution (Vaisman et al, 1988), as well as in bioimpedance analysis (Polito et al, 1998;Scalfi et al, 1999), have been observed after weight recovery.…”

Section: Introductionmentioning

confidence: 99%

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Body composition changes in patients with anorexia nervosa after complete weight recovery

Scalfi¹,

Polito

Bianchi

et al. 2002

Eur J Clin Nutr

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Objective: To assess body composition changes occurring in female anorectic patients after complete weight recovery. Design: Longitudinal study. Subjects: Ten female patients with anorexia nervosa (age at baseline: 19.7 AE 5.8 y) were studied both when undernourished (body mass index, BMI 14.8 AE Interventions: Fat mass and fat-free mass were determined by dual-energy X-ray absorptiometry. Skinfold thicknesses and circumferences were also measured. Arm muscle area and arm fat area were calculated by standard formulas. Results: The undernourished patients had lower fat-free mass, fat mass, skinfold thicknesses and circumferences. After refeeding, fat mass represented 25 -71% (mean 56%) of the mass regained, this percentage being directly related to the extent of weight gain. The increases in skinfolds and circumferences depended upon the site considered and were correlated to a various extent with those in weight or BMI. Skinfolds at biceps and abdominal sites and the waist-to-hip ratio remained significantly higher, whereas arm muscle circumference was significantly lower, in the refed group than in the control one. Conclusion: The percentage of fat in the weight regained by refed female anorectic patients was directly related to the extent of body mass increase. Refed anorectic patients appear to preferentially regain fat in the abdominal and triceps regions. Abnormalities in skinfolds (at biceps and abdominal sites), arm muscle area and waist-to-hip ratio still persist in refed anorectic patients in comparison to control healthy controls.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Body composition changes in patients with anorexia nervosa after complete weight recovery

Scalfi¹,

Polito

Bianchi

et al. 2002

Eur J Clin Nutr

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“…Fat mass-related parameters (TSF, SSF and AFA) appeared clustered under the 10th percentile (100%, 79%, 93% of the patients, respectively), while MAC, which is considered a better marker of muscle mass than fat mass, AMC and AMA were found in 43, 64 and 64% of the patients, respectively, above the 10th percentile (Frisancho, 1981). Several authors have also found a greater impairment of fat mass than muscle mass in undernourished AN patients (Russell et al, 1983;Forbes et al, 1984;Melchior et al, 1989;Krahn et al, 1993;Probst et al, 1996;Polito et al, 1998). Beaumont et al, (1993) suggest that a relatively high protein diet, together with the high physical activity levels that are characteristics of the illness, both features found in the patients of this study, will play a nitrogen-sparing role, which will explain initial weight loss being due almost entirely to loss of adipose tissue.…”

Section: Discussionmentioning

confidence: 96%

A one-year follow-up study in anorexia nervosa. Dietary pattern and anthropometrical evolution

et al. 2001

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Objective: To ®nd out the modi®cations and the interrelationships between the energy and macronutrient intakes and anthropometric measurements of a group of anorexia nervosa patients (ANP), with homogenous diagnosis, age and treatment, during a 1 y follow-up. Design: Longitudinal study design. Subjects: Fourteen restricting-type ANP in the adolescent age (11 ± 21 y) were recruited for the study and evaluated at four time intervals during 1 y of multidisciplinary treatment: (a) on admission (AN0); (b) after 1 month (AN1); (c) after 6 months (AN6); (d) after 1 y (AN12). Measures: Energy and macronutrient composition of the diet (48 h recall) and anthropometric measurements including skinfold thickness. Results: Mean weight and BMI were under the 3rd percentile in AN0. All anthropometrical parameters increased signi®cantly in AN1 compared to AN0 and did not change in AN6 and AN12. Energy and macronutrient intakes increased signi®cantly in AN1. The dietary changes were not maintained in the subsequent time intervals and there was an overall tendency to turn back to AN0 results. Energy intake adequacy to Spanish Recommended Intakes (RI) showed only an acceptable ratio in AN1 (94% RI); however, a preserved protein intake was found throughout the study (mean intakes between 128.5% and 230.0% RI). Negative correlations were found at AN12 between size of arm's subcutaneous fat stores and energy and macronutrient intakes. Conclusion: In this 1 y follow-up study the decrease in the intake of energy and macronutrients after discharge seems to be related to anthropometric evolution, so that a return to restrictive eating behaviour had occurred in those subjects who had reached the highest values in their subcutaneous fat stores, probably related to dissatisfaction with self-body image.

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“…The limitations of BMI alone become apparent, for example, when trying to predict resumption of menses (Sobanski et al, 1997;Falk & Halmi, 1982). Studies in adults, using more complex body composition models than BMI, have attempted to tease out the relationship between FM and normal endocrine function (Birmingham et al, 1996;Mazess et al, 1990;Probst et al, 1996;Vaisman et al, 1988;Zamboni et al, 1997). However, recent evidence suggests that FFM may be as or more important than fatness in the development of osteoporosis in AN (Grinspoon et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

Body composition in early onset eating disorders

Nicholls¹,

Wells²,

Singhal³

et al. 2002

Eur J Clin Nutr

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Background: Body mass index (BMI) or equivalent weight for height indices are the most widely used measures of body composition in early onset and adolescent eating disorders. Although of value as screening instruments the limitation in disease states is their inability to discriminate fat and fat-free components of body weight. Objective: To compare height-adjusted fat and fat-free components of body composition in children and young adolescents with different types of eating disorders with those of age matched reference children. Design: Weight, height, triceps and subscapular skinfold thickness were measured in 172 children (aged 7 -16 y) with eating disorders receiving specialist treatment. Fat mass index (FMI) and fat-free mass index (FFMI) were calculated using Slaughter's and Deurenberg's equations and normalisation for height. Using data from 157 normal children, representative of the UK 1990 growth reference data, reference curves for FMI and FFMI AE 2 s.d. were derived. Results for patient groups were superimposed on these reference curves.Results: FMI and FFMI were both reduced in eating disorders associated with malnutrition, including anorexia nervosa (AN). AN subjects did not differ from other subjects with comparable degrees of malnutrition. Children with eating disorders of normal weight, such as bulimia nervosa and selective eating, did not differ significantly from reference children in their relative FM and FFM. Conclusions: FM and FFM merit independent consideration in disorders of malnutrition in children, rather than expressing data as percentage body fat or percentage BMI. The implications of loss of FFM on growth and development merit further investigation.

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Body composition in female anorexia nervosa patients

Cited by 53 publications

References 52 publications

Body composition changes in patients with anorexia nervosa after complete weight recovery

Body composition changes in patients with anorexia nervosa after complete weight recovery

A one-year follow-up study in anorexia nervosa. Dietary pattern and anthropometrical evolution

Body composition in early onset eating disorders

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