Altered body fat distribution after recovery of weight in patients with anorexia nervosa

Iketani, Toshiya; Kiriike, Nobuo; Nagata, Toshihiko; Yamagami, Sakae

doi:10.1002/(sici)1098-108x(199911)26:3<275::aid-eat4>3.0.co;2-i

Cited by 42 publications

(26 citation statements)

References 13 publications

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“…We think that the fact that we used multifrequency assessment and placed the electrodes in proximal position (patella-sternum) may have reduced the discrepancies between data from one and another method. Iketani, Kiriike, Nagata, and Yamagami (1999) have demonstrated that after recovery AN patients tend to accumulate fat in the trunk, more than in the extremities, with a ''central obesity'' pattern of fat restoration. In accorance with these results, it can be observed how in our sample the differences between BN-AN and BN-nonAN groups are higher for trunk skinfolds (subscapular and suprailiac), than for arm skinfolds (tricipital and bicipital).…”

Section: Discussionmentioning

confidence: 77%

History of anorexia nervosa in bulimic patients: Its influence on body composition

Vaz

Guisado

Peñas-Lledó

2003

Intl J Eating Disorders

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Objective: To analyze the body composition of a group of patients fulfilling DSM-IV criteria for bulimia nervosa (BN), comparing the patients who had a history of DSM-IV anorexia nervosa (AN) with those without such a history to determine (1) whether both groups differed in terms of body composition and (2) whether the differences between groups could be the consequence of the past condition. Methods: The sample consisted of 104 patients, 43 with prior AN (BN-AN group) and 61 without a history of AN (BN-nonAN). The patients were assessed using anthropometric and bioelectrical methods: height and weight, body circumferences, abdominal diameter, skinfold thickness, and body impedance analysis. In a later phase and to test the influence of current low weight on the results, two experimental groups were created: the first group was composed of the patients from the BN-AN group who had a normal body mass index (BMI range in this group, 20.1-23.4 kg/m 2 ; n ¼ 23); the second group consisted of 23 patients from the BN-nonAN group in the same BMI range. In both phases unpaired sample t tests were performed for statistical analysis. Results: More than 40% of the bulimic patients with a history of AN had a BMI less than 20. They had a lower percentage of body fat, lower muscle mass, and higher percentage of extracellular water. Nevertheless, most of these differences disappeared in the second phase of the analysis, when only the patients within a normal weight range were compared. Discussion: According to these results, a significant number of bulimic patients with a history of AN tend to retain some clinical traits of the past condition and could be viewed as remaining in a ''subclinical anorexic status'': they are thinner and seem to have less difficulties in maintaining low weight than patients without a history of AN. Nevertheless, in patients who have reached a normal weight after AN, all these differences disappear. This fact raises some important questions related to the boundaries between AN and BN, the shifting from one to another, or when AN patients really recover. #

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Section: Discussionmentioning

confidence: 77%

History of anorexia nervosa in bulimic patients: Its influence on body composition

Vaz

Guisado

Peñas-Lledó

2003

Intl J Eating Disorders

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“…In adults, weight gain is accompanied by a significant increase in trunk fat with central adiposity (4,15,16). This has also been reported in partially weight recovered adolescents (11), suggesting that central adiposity may develop in these girls.…”

Section: Discussionmentioning

confidence: 99%

Regional fat distribution in adolescents with anorexia nervosa: effect of duration of malnutrition and weight recovery

Álvaro¹,

Muñoz-Calvo²,

Barrios³

et al. 2007

eur j endocrinol

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Objective: This study addresses the influence of the duration of malnutrition and the effect of weight recovery on regional fat mass distribution in moderately malnourished adolescents with anorexia nervosa (AN). Study design: We measured total and regional fat mass and leptin levels in 42 restrictive AN female adolescents and 23 controls. AN patients, followed over 2 years, were divided into three groups: prolonged moderate malnutrition (PM; secondary amenorrhea for over 1 year, nZ14); SM, short period of moderate malnutrition (secondary amenorrhea for less than 1 year, nZ13); and R, recovered from AN (BMI, body mass index and menses recovered for over 6 months, nZ15). Results: Total, trunk, and extremity fat mass were reduced in the PM and SM groups (P!0.05), whereas only PM patients showed altered regional fat distribution with a low trunk to extremity fat ratio (P!0.05). BMI increased after 12 months only in the SM group (P!0.05), with menses resumption in 69% of these patients and BMI normalization at 24 months. Their regional fat distribution was similar to controls throughout the study. No difference in any parameter was found between the R group and the controls. Conclusion: Prolonged malnutrition, but not weight recovery, is associated with an abnormal regional fat distribution pattern in moderately malnourished AN adolescents.European Journal of Endocrinology 157 473-479

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“…Actually, very low percentages of body fat were observed in anorectic patients using DXA by other authors (Waller et al, 1996;Iketani et al, 1999), while a difference between the two methods had previously been detected also by Waller et al (1996). Indeed, the differences between DXA and the skinfold thickness method were quite similar in the three experimental groups and were not affected by the absolute amount of body fat (data not shown; see below for comments on changes due to refeeding).…”

Section: Discussionmentioning

confidence: 99%

“…Altogether, these findings suggest that in refed anorectic patients there is a disproportionate recovery of body compartments which affects -first of all -subcutaneous fat, and support the hypothesis that body composition is not completely normalised after weight recovery (Iketani et al, 1999).…”

Section: Discussionmentioning

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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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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Altered body fat distribution after recovery of weight in patients with anorexia nervosa

Cited by 42 publications

References 13 publications

History of anorexia nervosa in bulimic patients: Its influence on body composition

History of anorexia nervosa in bulimic patients: Its influence on body composition

Regional fat distribution in adolescents with anorexia nervosa: effect of duration of malnutrition and weight recovery

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

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