In anorexia nervosa, even a small increase in abdominal fat is responsible for the appearance of insulin resistance

Abstract

Although weight-recovery represents the main aim of treatment in AN, refeeding is associated with an increase in abdominal fat which might be responsible of the onset of insulin resistance. As BMI and weight-recovery were associated with impaired IS, they cannot be considered the only aim of treatment of AN.

Anorexia Nervosa and Body Fat Distribution: A Systematic Review

“…In another DXA study, Mayer et al assessed body fat distribution in 29 women with anorexia nervosa and 15 age- and BMI-matched controls, finding no significant differences in percentage trunk fat between the two groups [14]. This was confirmed by Prioletta et al , who assessed regional body fat in 19 women with anorexia nervosa and 21 age-matched controls via DXA, and reported no difference in percentage trunk fat between the two groups [35]. Likewise, Grinspoon et al found no difference in trunk/extremity fat ratio between underweight young adult females with anorexia nervosa and healthy controls [32].…”

“…More recently, Prioletta et al used DXA to assess regional body fat after a small weight gain in 19 females with anorexia nervosa and 21 age-matched controls (BMI from 13.6 ± 1.8 to 14.4 ± 1.1). They also found preferential redistribution of fat mass in the trunk region with respect to controls [35]. Similarly, we used DXA to measure body composition, in a larger sample of 50 women with anorexia nervosa and 100 healthy age- and BMI-matched controls [36].…”

“…Prioletta et al reported that the preferential truncal redistribution of fat mass with respect to controls was correlated with insulin resistance status, and strictly paralleled by a reduction in insulin sensitivity as compared to controls [35]. We, on the other hand, have shown that the preferential distribution of body fat in central regions associated with short-term complete weight restoration does not seem to significantly influence eating disorder psychopathology or psychological distress in patients with anorexia nervosa [36].…”

“…Strong evidence suggests that: (I) Adult females with anorexia nervosa lose more peripheral (subcutaneous, extremity) rather than central body fat (visceral, trunk, android) during the course of their illness [14,32,35,36]; (II) Adolescent females with anorexia nervosa, in contrast, lose more central (trunk, visceral) than peripheral body fat (subcutaneous, extremity) [22,23,24,25]; (III) Both adolescent and adult females, although emaciated, conserve a normal body fat distribution pattern (waist to hip or android/gynoid ratios) [28,29,32,33,36]; (IV) In adult females with anorexia nervosa, short-term partial and complete weight restoration is associated with preferential trunk fat accumulation with central adipose deposition [14,30,31,32,35,36,40]. None of these four findings require further replication.…”

Muscle function and body composition profile in adolescents with restrictive anorexia nervosa: does resistance training help?

“…There is scarce research focusing on short-and long-term effects of central fat changes on health-related parameters in AN-R patients, although excessive BF has been associated with risk for development of chronic and metabolic diseases [17]. However, one study has reported that small changes in central fat in AN patients were associated with a decreased insulin sensitivity, that could eventually result in an increased risk of developing metabolic and cardiovascular-related diseases [40].…”