Changes in body composition in anorexia nervosa: Predictors of recovery and treatment outcome

Zaida Agüera, Xandra Romero, Jon Arcelus, Isabel Sánchez, Nadine Riesco, Susana Jiménez-Murcia, Jana González-Gómez, Roser Granero, Nuria Custal, Monica Montserrat Gil De Bernabé, Salomé Tárrega, Rosa M. Baños, Cristina Botella, Rafael De La Torre, José C. Fernández-García, José M. Fernández-Real, Gema Frühbeck, Javier Gómez-Ambrosi, Francisco J. Tinahones, Ana B. CrujeirasFelipe F. Casanueva, José M. Menchón, Fernando Fernández-Aranda

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© 2015 Agüera et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The restoration of body composition (BC) parameters is considered to be one of the most important goals in the treatment of patients with anorexia nervosa (AN). However, little is known about differences between AN diagnostic subtypes [restricting (AN-R) and binge/purging (AN-BP)] and weekly changes in BC during refeeding treatment. Therefore, the main objectives of our study were twofold: 1) to assess the changes in BC throughout nutritional treatment in an AN sample and 2) to analyze predictors of BC changes during treatment, as well as predictors of treatment outcome. The whole sample comprised 261 participants [118 adult females with AN (70 AN-R vs. 48 AN-BP), and 143 healthy controls]. BC was measured weekly during 15 weeks of day-hospital treatment using bioelectrical impedance analysis (BIA). Assessment measures also included the Eating Disorders Inventory-2, as well as a number of other clinical indices. Overall, the results showed that AN-R and AN-BP patients statistically differed in all BC measures at admission. However, no significant time×group interaction was found for almost all BC parameters. Significant time×group interactions were only found for basal metabolic rate (p = .041) and body mass index (BMI) (p = .035). Multiple regression models showed that the best predictors of prepost changes in BC parameters (namely fat-free mass, muscular mass, total body water and BMI) were the baseline values of BC parameters. Stepwise predictive logistic regressions showed that only BMI and age were significantly associated with outcome, but not with the percentage of body fat. In conclusion, these data suggest that although AN patients tended to restore all BC parameters during nutritional treatment, only AN-BP patients obtained the same fat mass values as healthy controls. Put succinctly, the best predictors of changes in BC were baseline BC values, which did not, however, seem to influence treatment outcome.
Original languageEnglish
Article numbere0143012
JournalPLoS ONE
Publication statusPublished - 1 Nov 2015


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