Long-term Nutritional Follow-up is Essential for Anorectic Patients

Reprinted from Eating Disorders Review
March/April 2004 Volume 15, Number 2
©2004 Gürze Books

Even though patients have completely recovered from anorexia nervosa, they may need continued nutrition surveillance and support throughout their lifetimes, according to the results of a recent study (Acta Diabetol 2004;41:18).

Dr. S. Bertoli and colleagues at the International Center for the Assessment of Body Composition at the University of Milan, Italy, investigated the time course of body composition during and after refeeding in 32 female patients with anorexia nervosa. The patients were enrolled in the study when they were at their lowest weight, then re-examined after they achieved a 15% weight gain over a mean of 3 months. They were then re-examined after they had had stable weight recovery for 3 years. Beginning at 3 months, the patients were compared to a control group of 8 healthy females matched for age and body mass index. All participants in the study underwent dual x-ray absorptiometry at each visit.

At the initial visit, the 32 subjects were at 61% of their ideal body weight (IBW) and had severe reductions in fat mass (+7.1%+ to -4.5%), fat-free mass and bone mineral content. At 3 months, 8 subjects had gained 40% of their initial weight but still were 85% of their ideal body weight, with a percentage of fat mass comparable to that of controls and an absolute fat-free mass that was still deficient. Bone mineral content did not improve at 3 months, and remained 79% of that of the healthy controls.

The depletion of fat mass was more severe in the limbs than in the trunk, and at 3 months the trunk/limb ratio remained greater that that recorded in the controls. The authors feel these data strongly suggest that continued nutritional surveillance and support should continue throughout anorexic patients’ lives, even after the psychiatric illness and severe underweight are corrected.

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