Anorexia Nervosa and Body Fat Distribution: A Systematic Review

Abstract

The aim of this paper was to conduct a systematic review of body fat distribution before and after partial and complete weight restoration in individuals with anorexia nervosa. Literature searches, study selection, method development and quality appraisal were performed independently by two authors, and data was synthesized using a narrative approach. Twenty studies met the inclusion criteria and were consequently analyzed. The review had five main findings. First, during anorexia nervosa adolescent females lose more central body fat, while adult females more peripheral fat. Second, partial weight restoration leads to greater fat mass deposition in the trunk region than other body regions in adolescent females. Third, after short-term weight restoration, whether partial or complete, adults show a central adiposity phenotype with respect to healthy age-matched controls. Fourth, central fat distribution is associated with increased insulin resistance, but does not adversely affect eating disorder psychopathology or cause psychological distress in female adults. Fifth, the abnormal central fat distribution seems to normalize after long-term maintenance of complete weight restoration, indicating that preferential central distribution of body fat is a transitory phenomenon. However, a discrepancy in the findings has been noted, especially between adolescents and adults; besides age and gender, these appear to be related to differences in the methodology and time of body composition assessments. The PROSPERO Registry—Anorexia Nervosa and Body Fat Distribution: A Systematic Review (CRD42014008738).

Body composition in men with anorexia nervosa: Longitudinal study

“…Since this is the first study to assess body composition in men with anorexia nervosa, we are not able to compare this finding with previous studies in this population. Nevertheless, it should be mentioned that a similar change in body composition patterns has previously been reported in female patients with anorexia nervosa (El Ghoch, Calugi, Lamburghini, & Dalle Grave, ).…”

Gut microbiota and body composition in anorexia nervosa inpatients in comparison to athletes, overweight, obese, and normal weight controls

“…Stool samples were acquired 10.61 ± SD 13.01 days after hospital admission. All AN inpatients were encouraged to adhere to a mixed diet because an appropriate caloric intake helps to avoid refeeding complications and an excessive gain of weight is detrimental and a major risk factor for relapse (El Ghoch, Calugi, Lamburghini, & Dalle Grave, ).…”

Body composition in anorexia nervosa: Meta‐analysis and meta‐regression of cross‐sectional and longitudinal studies

“…Anorexia nervosa (AN) has one of the highest mortality rates of all psychiatric disorders (Chesney, Goodwin, & Fazel, ). Clinical observations show altered body composition (El Ghoch, Calugi, Lamburghini, & Dalle Grave, ; Solmi et al, ) accompanied by elevated cholesterol (Hussain et al, ) and greater insulin sensitivity (Ilyas et al, ). However, conclusions are limited by small sample sizes and consequent mixed findings.…”

“…A systematic review showed that adolescents and adults differently lose fat tissue when affected by AN, with adolescents losing more central fat tissue and adults more peripheral fat tissue. During weight recovery, individuals with AN show emergent central adiposity which typically attenuates over time (El Ghoch, Calugi, et al, ). These clinical and genetic findings encourage the meta‐analytic reassessment of the role of body composition traits, such as fat mass and fat‐free mass, their regional distribution, and their changes associated with weight restoration and long‐term weight recovery in AN.…”