Body Composition after Weight Gain

The pattern of fat distribution changed in patients with anorexia nervosa.

Reprinted from Eating Disorders Review
July/August Volume 25, Number 4
©2014 iaedp

Nutritional rehabilitation and weight regain are crucial steps to recovery for patients with anorexia nervosa (AN). A recent longitudinal study evaluated total body composition and regional fat mass distribution before and after weight restoration among 50 adults with AN and 100 healthy controls (Am J Clin Nutr. 2014; 99:771).

Using dual-energy x-ray absorptiometry (DXA), Dr. Marwan El Ghoch and a team at Villa Garda Hospital, Garda, Italy, and the universities of Verona and Modena and Reggio Emilia, also in Italy, tracked fat distribution and also measured eating disorder psychopathology and psychological distress among the participants with the Eating Disorder Examination (EDE).

After refeeding, greater central body fat deposition

Three main findings emerged. First, before treatment, it was not surprising that patients with AN had lower scores than did controls on virtually all measures (body mass index, total lean and fat mass, and percentage of body fat). After weight restoration, however, no significant differences in these variables were seen. Second, after 20 weeks of treatment, AN patients had higher central body fat percentages than did controls. This was particularly marked in the android (abdomen and trunk) and gynoid (hips and thighs) regions, with lower fat percentages in the peripheral regions. This finding echoed former data showing that during rapid weight gain, patients with AN tend to deposit fat centrally. Third, eating disorder psychopathology was not related to either baseline or end-of-treatment body composition variables.

Dr. El Ghoch and colleagues suggest that “the absence of any detectable relationship between body composition variables and eating disorder psychopathology be openly discussed with patients.” Such a discussion could help patients direct their attention to the underlying psychological mechanisms that maintain their body image disturbance rather than to efforts to change their body shape. The authors also suggest that future clinical studies could examine the medical implications of increased truncal fat in women with AN after regaining weight.

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