Inpatient Weight Restoration Treatment Is Associated with Decrease in Post-Meal Anxiety

Abstract

Objective: Anorexia nervosa (AN) is characterized by weight loss, distorted body image with fear of becoming fat and associated with anxiety, especially in relation to food intake. Anxiety in relation to meals and weight restoration remains a major challenge in the treatment of AN. We examined the effects of inpatient weight restoration treatment on levels of post-meal anxiety using visual analogue scale (VAS) ratings in patients with AN. Materials: Thirty-two patients with AN, all part of the PROspective Longitudinal all-comer inclusion study on Eating Disorders (PROLED) were followed over eight weeks with baseline psychometric measures and weekly VAS anxiety self-scoring. Methods: Apart from the weekly body mass index (BMI) and VAS, patients were characterized at baseline using the Eating Disorder Examination Questionnaire (EDE-Q), Eating Disorder Inventory (EDI), Symptom Check List 92 (SCL-92), Major Depression Inventory (MDI), and Autism Quotient (AQ). Results: The results showed a significant time effect, Wilks Lambda = 0.523, F = 3.12, p < 0.05 (power of 0.862), indicating a reduction in VAS scores of anxiety from baseline to week 8. There was no effect of baseline medication or scores of MDI on the results. BMI increased from a mean of 15.16 (week 1) to 17.35 (week 8). In comparison, patients dropping out after only three weeks (n = 31) also had a trend toward a reduction in VAS anxiety (ns). Conclusions: Inpatient weight restoration treatment is associated with a decrease in post-meal anxiety in AN, an effect that occurs early and becomes clinically significant in patients who stay in treatment.

Anorexia Nervosa: Reduction in Depression during Inpatient Treatment Is Closely Related to Reduction in Eating Disorder Psychopathology

“…Depression was assessed by the MDI, a self-assessment questionnaire, which has been validated and proved to be a reliable and sensitive method in several studies on AN [ 17 , 18 ]. The test-retest reliability of the MDI has been studied in a variety of different populations; however, to our knowledge, not explicitly in weight stable patients with AN.…”

“…Participants in this study were all enrolled in the PROspective Longitudinal all-comer inclusion study on EDs (PROLED), which has been described previously [ 18 ]. In total, forty-nine individuals, 46 women and 3 men who all met the ICD-10 criteria for AN at the time of hospital admission [ 19 ], and were aged between 18 and 52 years, took part in this study on weight gain.…”

“…The participants were undergoing multidisciplinary inpatient therapy with support for meals and rest as previously described [ 18 ].…”

Are the Effects of Malnutrition on the Gut Microbiota–Brain Axis the Core Pathologies of Anorexia Nervosa?

“…No pharmacological treatments have been shown to be effective in treating AN [ 1 , 16 ]. If a patient is able to engage in therapy and their malnutrition is reduced, postmeal anxiety and fear of weight gain usually gradually subside [ 17 ]. The vicious cycle described in Figure 1 is gradually broken down if treatment is successful.…”

“…During successful treatment, postmeal anxiety gradually decreases in parallel with a reduction in malnutrition [ 17 ]. Patients who are able to complete treatment including establishing a BMI >20 kg/m 2 and addressing persistent psychological mechanisms often enter long-term remission or are cured [ 3 , 7 , 15 , 56 ].…”