Q & A: Body Fat Pattern After Weight Gain in Anorexia Nervosa

Q: I’ve read that the body’s fat pattern changes after weight gain in patients with anorexia nervosa, and that some of these patients tend to accumulate body fat during weight recovery. This topic has arisen during my work several times recently. In my research, I have never been able to find the answer to the question as to whether or not the weight distribution normalizes over time. Do you know whether or not this accumulation of fat is only temporary? Does it normalize over long-term weight maintenance? ( J.S., Nashville, TN)

A: Excellent question. Although there’s no definitive research at this point, my own experience, and that of a number of other clinicians who’ve observed these phenomena, including some who participated in a recent study (Am J Clin Nutr 2005; 81:1286), is that the fat does redistribute to a more usual, less centripetal, pattern after a period of months. Some of my own patients believe that their return to healthy exercise (not compulsive over-exercise) may have helped in this process. My unsystematic observations are that after several years women who have recovered from anorexia nervosa have pretty much the same fat distribution pattern as others—and fat patterns similar to those they had prior to getting sick initially.

— J.Y.