Early Course of Symptom Development in Anorexia Nervosa

Ranzenhofer, Lisa M.; Jablonski, Monica; Davis, Lauren Evoy; Posner, Jonathan; Walsh, Brittany; Steinglass, Joanna E.

doi:10.1016/j.jadohealth.2022.06.010

Cited by 8 publications

(3 citation statements)

References 36 publications

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“…If allowed to continue unchecked, the ABA paradigm results in hypothermia, increased HPA axis activity, and ultimately stomach ulceration and death (16,23,24). Younger animals lose body weight more rapidly than older animals during ABA (25), paralleling clinical observations that AN is a disorder with peak onset and prevalence during adolescence (26,27).…”

Section: Introductionsupporting

confidence: 61%

The attenuation of activity-based anorexia by obese adipose tissue transplant is AgRP neuron-dependent

Yoon,

Zhang,

Zapata

et al. 2024

Preprint

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Anorexia nervosa (AN) is an eating disorder observed primarily in girls and women, and is characterized by a low body mass index, hypophagia, and hyperactivity. The activity-based anorexia (ABA) paradigm models aspects of AN, and refers to the progressive weight loss, hypophagia, and hyperactivity developed by rodents exposed to time-restricted feeding and running wheel access. Recent studies identified white adipose tissue (WAT) as a primary location of the metabolic memory of prior obesity, and implicated WAT-derived signals as drivers of recidivism to obesity following weight loss. Here, we tested whether an obese WAT transplant could attenuate ABA-induced weight loss in normal female mice. Recipient mice received a WAT transplant harvested from normal chow-fed, or HFD-fed obese mice; obese fat recipient (OFR) and control fat recipient (CFR) mice were then tested for ABA. During ABA, OFR mice survived longer than CFR mice, defined as maintaining 75% of their initial body weight. Next, we tested whether agouti-related peptide (AgRP) neurons, which regulate feeding behavior and metabolic sensing, mediate this effect of obese WAT transplant. CFR and OFR mice received either control or neonatal AgRP ablation, and were assessed for ABA. OFR intact mice maintained higher body weights longer than CFR intact mice, and this effect was abolished by neonatal AgRP ablation; further, ablation reduced survival in OFR, but not CFR mice. In summary, obese WAT transplant communicates with AgRP neurons to increase body weight maintenance during ABA. These findings encourage the examination of obese WAT-derived factors as potential treatments for AN.

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Section: Introductionsupporting

confidence: 61%

The attenuation of activity-based anorexia by obese adipose tissue transplant is AgRP neuron-dependent

Yoon,

Zhang,

Zapata

et al. 2024

Preprint

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“…In our study, premorbid PA1-6 only correlated significantly with PA before the onset of AN, not with PA after the onset of AN, change of PA (%) after the onset of AN, or objectively assessed PA (steps/d) on admission to inpatient treatment. These findings suggest that high premorbid PA might not automatically be a predictor for increased PA during the course of AN, yet it does not exclude the possibility that premorbid PA might be a risk factor for individuals or a subgroup [ 23 ]. In contrast, Davis et al concluded that a serious commitment to exercise has significance in creating a psychological predisposition to an eating disorder and is a contributing factor in its progression [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Patient Self-Reported, Pre-Morbid Physical Activity and Clinical Outcomes of Inpatient Treatment in Youth with Anorexia Nervosa: A Pilot Study

Pech,

Correll,

Schmidt

et al. 2024

Nutrients

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Links between premorbid physical activity (PA) and disease onset/course in patients with anorexia nervosa (AN) remain unclear. The aim was to assess self-reported PA as a predictor of change in percent median BMI (%mBMI) and length of hospital stay (LOS). Five PA domains were assessed via semi-structured interview in adolescents with AN at hospitalization: premorbid PA in school grades 1-6 (PA1-6); PA before AN onset (PA-pre) and after AN onset (PA-post); new, pathological motivation for PA (PA-new); and high intensity PA (PA-high). Eating disorder psychopathology was measured via the Eating Disorder Examination Questionnaire (EDE-Q), and current PA (steps/day) with accelerometry. PA1-6 was also assessed in healthy controls (HCs). Using stepwise backward regression models, predictors of %mBMI change and LOS were examined. Compared with 22 HCs (age = 14.7 ± 1.3 years, %mBMI = 102.4 ± 12.1), 25 patients with AN (age = 15.1 ± 1.7 years, %mBMI = 74.8 ± 6.0) reported significantly higher PA1-6 (median, AN = 115 [interquartile range IQR = 75;200] min vs. HC = 68 [IQR = 29;105] min; p = 0.017). PA-post was 244 ± 323% higher than PA-pre. PA1-6 was directly associated with PA-pre (p = 0.001) but not with PA-post (p = 0.179) or change in PA-pre to PA-post (p = 0.735). Lower %mBMI gain was predicted by lower baseline %mBMI (p = 0.001) and more PA-high (p = 0.004; r2 = 0.604). Longer LOS was predicted by higher PA-pre (p = 0.003, r2 = 0.368). Self-reported PA may identify a subgroup of youth with AN at risk of less weight gain and prolonged LOS during inpatient treatment for AN.

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“…In terms of age at onset, our findings align with prior research reporting older age at onset in patients with binge-eating/purging AN (AN-BP) as compared with those with restricting AN (AN-R) [ 44 ]. Moreover, there is evidence suggesting a later onset of purging relative to other pathological eating habits, including binging, in previously healthy adolescents [ 45 ]. Interestingly, dieting seems to be the first symptom of AN, with purging and other attitudes occurring later in the progression of the disorder [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Factors Associated with Binge-Eating Episodes or Purging Behaviors in Patients Affected by Eating Disorders: A Cross-Sectional Study

Caldiroli,

Affaticati,

Coloccini

et al. 2024

JPM

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The aim of the present study was to investigate the potential associations between clinical/socio-demographic variables and the presence of purging/binge-eating episodes in eating disorders (EDs). Clinical/socio-demographic variables and psychometric scores were collected. Groups of patients were identified according to the presence or absence of purging or objective binge-eating episodes (OBEs) and compared through t-test and chi-square tests. Binary logistic regression analyses were run. A sample of 51 ED outpatients was recruited. Patients with purging behaviors had a longer duration of untreated illness (DUI) (t = 1.672; p = 0.019) and smoked a higher number of cigarettes/day (t = 1.061; p = 0.030) compared to their counterparts. A lower BMI was associated with purging (OR = 0.881; p = 0.035), and an older age at onset showed a trend towards statistical significance (OR = 1.153; p = 0.061). Patients with OBEs, compared to their counterparts, were older (t = 0.095; p < 0.001), more frequently presented a diagnosis of bulimia or binge-eating disorder (χ2 = 26.693; p < 0.001), a longer duration of illness (t = 2.162; p = 0.019), a higher number of hospitalizations (t = 1.301; p = 0.012), and more often received a prescription for pharmacological treatment (χ2 = 7.864; OR = 6.000; p = 0.005). A longer duration of the last pharmacological treatment was associated with OBE (OR = 1.569; p = 0.046). In contrast to purging, OBE was associated with a more complicated and severe presentation of ED. A lower BMI and a later age at onset, as well as long-lasting previous pharmacological treatments, may predict the presence of purging/binging. Further research is needed to thoroughly characterize ED features and corroborate our preliminary findings.

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Early Course of Symptom Development in Anorexia Nervosa

Cited by 8 publications

References 36 publications

The attenuation of activity-based anorexia by obese adipose tissue transplant is AgRP neuron-dependent

The attenuation of activity-based anorexia by obese adipose tissue transplant is AgRP neuron-dependent

The Relationship between Patient Self-Reported, Pre-Morbid Physical Activity and Clinical Outcomes of Inpatient Treatment in Youth with Anorexia Nervosa: A Pilot Study

Clinical Factors Associated with Binge-Eating Episodes or Purging Behaviors in Patients Affected by Eating Disorders: A Cross-Sectional Study

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