The impact of weight suppression and weight loss speed on baseline clinical characteristics and response to treatment

Solmi, Marco; Gallicchio, Davide; Collantoni, Enrico; Meneguzzo, Paolo; Zanetti, Tatiana; Degortes, Daniela; Tenconi, Elena; Bonello, Elisa; Veronese, Angela; Ronzan, Andrea; Favaro, Angela

doi:10.1002/eat.22861

Cited by 21 publications

(23 citation statements)

References 43 publications

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“…However, as all patients had regained to a minimally normal weight, they were undoubtedly less weight‐suppressed than prior to admission to acute treatment, and it is possible that a greater degree of WS would have manifested an effect on clinical outcome. On the other hand, the mean WS of our group was similar to that of several other studies which found a significant relationship between WS and eating disorder symptoms (Burnette, Simpson, & Mazzeo, 2017, 2018; Solmi et al, 2018). We examined the definition of WS used by most prior studies.…”

Section: Discussionsupporting

confidence: 91%

“…While several studies have found that WS and/or its interaction with BMI predict change in weight during treatment (Berner et al, 2013; Carter et al, 2015; Piers et al, 2019; Wildes & Marcus, 2012), WS has not been shown to consistently relate to other indices of treatment outcome, such as likelihood of drop‐out (Solmi et al, 2018; Wildes & Marcus, 2012), achieving weight restoration (Witt et al, 2014), duration of illness (Witt et al, 2014), or illness remission (Solmi et al, 2018). To our knowledge, only one other study to date has examined the influence of WS on weight trajectory following treatment in AN (Bodell et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…All patients in the current study received CBT, which may have impacted course. However, numerous studies examining WS in AN involve studies in which patients are receiving some form of psychotherapy treatment across a range of clinical settings (Berner et al, 2013; Carter et al, 2015; Solmi et al, 2018; Wildes & Marcus, 2012). Finally, although half the participants received fluoxetine, fluoxetine was previously found to have no effect on the rate of relapse or on changes in psychological symptoms (Walsh et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

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Weight suppression and weight maintenance following treatment of anorexia nervosa

Uniacke

Attia

Kaplan

et al. 2020

Intl J Eating Disorders

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Objective: The value of weight suppression (WS) in predicting the course of anorexia nervosa (AN) is uncertain. The objective of this study was to determine, using data from a previously published study, whether patients who remain weight suppressed following restoration to a minimally normal weight are at greater risk for relapse.Method: Following weight restoration, 93 women with AN were randomly assigned to receive fluoxetine or placebo along with cognitive behavioral therapy for 1 year. WS (highest adult weight minus current weight), body mass index (BMI), and their interaction were assessed as predictors of change in weight over the first 28 days, of successful weight maintenance at 6 and 12 months, and of time to relapse.Results: Neither WS nor its interaction with BMI predicted successful weight maintenance at 6 and 12 months, time to relapse, or weight change over the first 28 days following discharge.Discussion: This study found that WS does not substantially impact the likelihood of successful weight maintenance or time to relapse following restoration to a minimally normal weight in AN. K E Y W O R D Sanorexia nervosa, eating disorders, outcome, relapse, weight suppression

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Weight suppression and weight maintenance following treatment of anorexia nervosa

Uniacke

Attia

Kaplan

et al. 2020

Intl J Eating Disorders

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“…The reorganization of the brain network showed significant relationships with BMI and reduced volumes of gray matter, as an association was evident between differences in topological properties and differences in cortical volumes, particularly in the parietal cortex where lower levels of clusterization and efficiency were observed in the most affected areas. Further studies could be useful to evaluate the impact of weight loss as well as weight loss speed on brain network architecture (Solmi et al, 2018). Moreover, longitudinal evaluations are needed to better understand how much all these alterations are a consequence of malnutrition and how much weight gain is associated with a recovery of network brain organization.…”

Section: Discussionmentioning

confidence: 99%

Shift Toward Randomness in Brain Networks of Patients With Anorexia Nervosa: The Role of Malnutrition

et al. 2021

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No study to date investigated structural white matter (WM) connectome characteristics in patients with anorexia nervosa (AN). Previous research in AN found evidence of imbalances in global and regional connectomic brain architecture and highlighted a role of malnutrition in determining structural brain changes. The aim of our study was to explore the characteristics of the WM network architecture in a sample of patients with AN. Thirty-six patients with AN and 36 healthy women underwent magnetic resonance imaging to obtain a high-resolution three-dimensional T1-weighted anatomical image and a diffusion tensor imaging scan. Probabilistic tractography data were extracted and analyzed in their network properties through graph theory tools. In comparison to healthy women, patients with AN showed lower global network segregation (normalized clustering: p = 0.029), an imbalance between global network integration and segregation (i.e., lower small-worldness: p = 0.031), and the loss of some of the most integrative and influential hubs. Both clustering and small-worldness correlated with the lowest lifetime body mass index. A significant relationship was found between the average regional loss of cortical volume and changes in network properties of brain nodes: the more the difference in the cortical volume of brain areas, the more the increase in the centrality of corresponding nodes in the whole brain, and the decrease in clustering and efficiency of the nodes of parietal cortex. Our findings showed an unbalanced connectome wiring in AN patients, which seems to be influenced by malnutrition and loss of cortical volume. The role of this rearrangement in the maintenance and prognosis of AN and its reversibility with clinical improvement needs to be established by future studies.

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“…It is the first study that included patients at different AN stages of their disorder to investigate a possible role of disorder duration in determining hippocampal alterations and providing evidence that a reduced hippocampal volume is not to be considered an index of neuroprogression in AN (Treasure et al, 2015), since it is present from the very first stages of the disorder. Furthermore, the correlation between whole hippocampal volume and BMI is a particularly interesting finding because it helps in clarifying the possible causal role of malnutrition in the structural alteration of this brain area, although the role of weight suppression and speed of weight loss on brain atrophy remains to be understood and explored (Solmi et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Hippocampal volumes in anorexia nervosa at different stages of the disorder

Collantoni

Tenconi

Solmi

et al. 2020

Euro Eating Disorders Rev

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Introduction Hippocampus is involved in a range of cognitive and behavioural processes, and its volume has been found to be reduced in different psychiatric disorders. The present study aims at exploring hippocampal volumes in anorexia nervosa (AN) at different stages of the disorder (a few months after onset, more than 1 year after onset and after recovery). Methods Two samples were included in the present study. The first was composed of 58 patients (38 with present AN, 20 full recovered from AN) and 38 age‐matched healthy women (HW); the second, recruited at a different site, included 20 patients with AN and 16 HW. Hippocampal volume has been estimated using an automated segmentation algorithm. Age, site of scanning and total intracranial volumes were used as covariates in the statistical analyses. Results AN patients showed a reduced hippocampal volume in comparison to HW, with no substantial differences between patients with recent onset and those with a longer duration of illness. Among patients, hippocampal volumes correlated with body mass index, anxiety and drive for thinness. Discussion Our findings suggest an early role of malnutrition in the morphologic alterations of the hippocampus in AN and a possible role of this brain structure in mediating specific psychopathological traits.

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The impact of weight suppression and weight loss speed on baseline clinical characteristics and response to treatment

Cited by 21 publications

References 43 publications

Weight suppression and weight maintenance following treatment of anorexia nervosa

Weight suppression and weight maintenance following treatment of anorexia nervosa

Shift Toward Randomness in Brain Networks of Patients With Anorexia Nervosa: The Role of Malnutrition

Hippocampal volumes in anorexia nervosa at different stages of the disorder

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