High Resting Energy Expenditure in Normal-weight Bulimics and its Normalization with Control of Eating Behaviour

Research on energy expenditure in individuals with eating disorders: A review

“…Adjusted (for weight or FFM) REE has been shown to be low in patients with active BN compared with controls (Bennet, Williamson, & Powers, 1989;Devlin et al, 1990), suggesting a metabolic adaptation to the semistarvation generally occurring in BN patients. However, others have found that REE in the acute phase of the illness was similar (Detzer et al, 1994) or even higher (Leonard et al, 1996) compared with controls, suggesting that binge eating might increase REE and that BN patients are overfed rather than semistarved relative to controls. A tempting hypothesis is that BN patients may have an underlying abnormality of energy regulation, which is compensated for by bulimic behaviors.…”

Research on energy expenditure in individuals with eating disorders: A review

“…Adjusted (for weight or FFM) REE has been shown to be low in patients with active BN compared with controls (Bennet, Williamson, & Powers, 1989;Devlin et al, 1990), suggesting a metabolic adaptation to the semistarvation generally occurring in BN patients. However, others have found that REE in the acute phase of the illness was similar (Detzer et al, 1994) or even higher (Leonard et al, 1996) compared with controls, suggesting that binge eating might increase REE and that BN patients are overfed rather than semistarved relative to controls. A tempting hypothesis is that BN patients may have an underlying abnormality of energy regulation, which is compensated for by bulimic behaviors.…”

“…This finding supports reports of decreased energy requirements for weight maintenance in BN patients. Studies following BN patients longitudinally, however, have found either a reduction of REE after abstinence compared with the active phase of the illness (Altemus et al, 1991;Leonard et al, 1996) or no change (Detzer et al, 1994). A case report even found a 50% increase in REE after resumption of regular food intake (Sedlet & Ireton-Jones, 1989).…”

Total energy expenditure as measured by doubly‐labeled water in outpatients with bulimia nervosa

“…Other studies have suggested that RMR is dependent on degree of recovery, and one study found lowered RMR with 7 weeks of abstinence in bulimic women (Altemus et al, 1991). A recent study (Leonard et al, 1996) suggested that RMR was increased in the acute phase of BN and normalized after treatment. These discrepancies may be due to differences in methodology and in clinical status of the subjects, severity of binge eating and purging, impact of diet, smoking and physical activity, as well as differences in measurement techniques for RMR.…”

“…Resting metabolic rate (RMR), a major component of total energy expenditure, has been shown in some studies (Obarzanek, Lesem, Goldstein, & Jimerson, 1991;Bennett, Williamson, & Powers, 1989;Devlin et al, 1990) but not others (Leonard, Foulon, & Samuel-LaJeunesse, 1996;Detzer et al, 1994) to be low in women with BN as compared to controls. Other studies have suggested that RMR is dependent on degree of recovery, and one study found lowered RMR with 7 weeks of abstinence in bulimic women (Altemus et al, 1991).…”