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5. Enduring Changes in Decision Making in Patients with Full Remission from Anorexia Nervosa

Author

Steward, T, Mestre-Bach, G, Aguera, Z, Granero, R, Martin-Romera, V, Sanchez, I, Riesco, N, Tolosa-Sola, I, Fernandez-Formoso, JA, Fernandez-Garcia, JC, Tinahones, FJ, Casanueva, FF, Banos, RM, Botella, C, Crujeiras, AB, de la Torre, R, Fernandez-Real, JM, Fruehbeck, G, Ortega, FJ, Rodriguez, A, Jimenez-Murcia, S, Menchon, JM, Fernandez-Aranda, F, Steward, T, Mestre-Bach, G, Aguera, Z, Granero, R, Martin-Romera, V, Sanchez, I, Riesco, N, Tolosa-Sola, I, Fernandez-Formoso, JA, Fernandez-Garcia, JC, Tinahones, FJ, Casanueva, FF, Banos, RM, Botella, C, Crujeiras, AB, de la Torre, R, Fernandez-Real, JM, Fruehbeck, G, Ortega, FJ, Rodriguez, A, Jimenez-Murcia, S, Menchon, JM, and Fernandez-Aranda, F

Published
2016

12. Changes in Body Composition in Anorexia Nervosa : Predictors of Recovery and Treatment Outcome

Author

Cristina Botella, Mónica Montserrat-Gil de Bernabe, José M. Menchón, Salomé Tárrega, Ana B. Crujeiras, Nadine Riesco, Jon Arcelus, Javier Gómez-Ambrosi, Jana González-Gómez, Susana Jiménez-Murcia, Gema Frühbeck, Rafael de la Torre, José Carlos Fernández-García, Xandra Romero, Nuria Custal, Rosa M. Baños, Isabel Sánchez, Roser Granero, Fernando Fernández-Aranda, Francisco J. Tinahones, Felipe F. Casanueva, José Manuel Fernández-Real, Zaida Agüera, Universitat de Barcelona, [Agüera,Z, Romero,X, Sánchez,I, Riesco,N, Jiménez-Murcia,S, Custal,N, Montserrat-Gil de Bernabé,M, Menchon,JM, Fernández-Aranda,F] University Hospital of Bellvitge, IDIBELL, Department of Psychiat, Barcelona, Spain [Agüera,Z, Granero,R, Baños,RM, Botella,C, Torre,R de la, Fernández-García,JC, Fernández-Real,JM, Fruehbeck,G, Gómez-Ambrosi,J, Tinahones,FJ, Crujeiras,AB, Casanueva,FF, Fernández-Aranda,F] Instituto de Salud Carlos III, Madrid, Spain. [Arcelus,J] University of Loughborough, Centre for Research into Eating Disorders, Loughborough, Leics, England. [Jiménez-Murcia,S, Menchón,JM, Fernández-Aranda,F] University of Barcelona, School of Medicine, Departament of Clinical Sciences, Barcelona, Spain, [González-Gómez,J] Marqués de Valdecilla Public Foundation-Research Institute, Santander, Spain. [Granero,R, Tárrega,S] Universidad Autónoma de Barcelona, Department of Psychobiology & Methodology, Barcelona, Spain. [Montserrat-Gil de Bernabe,M] University Hospital of Bellvitge, Dietetic & Nutrition Unit, Barcelona, Spain. [Baños,RM] University of Valencia, Department of Personal Evaluation & Psychologic Treatment, Valencia, Spain. [Botella,C] Universidad Jaume 1, Department of Basic Psychology Clinic & Psychobiology, Castellon de La Plana, Spain. [Torre,R de la] IMIM Hospital del Mar Medical Research Institute, Neurosciences Research Program, Human Pharmacology & Clinical Neurosciences Research Group, Barcelona, Spain. [Fernández-García,JC, Tinahones,FJ] Hospital Clínico Universitario Virgen de la Victoria, Departamento de Diabetología, Endocrinología & Nutrición, Málaga, Spain. [Fernández-Real,JM] Hospital Dr. Josep Trueta, IdIBGi, Departamento de Diabetología, Endocrinología & Nutrición, Girona, Spain. [Fruehbeck,G, Gómez-Ambrosi,J] University of Navarra, University Navarra Clinic, Department Endocrinology & Nutrition, Pamplona, Spain, [Crujeiras,AB, Casanueva,FF] Complejo Hospitalario Universidad de Santiago, División Endocrine, Santiago de Compostela, Spain. [Menchón,JM] CIBER Salud Mental CIBERSAM, Barcelona, Spain., The study was supported by Instituto de Salud Carlos III [ISCIII, and FIS PI11/00210, FIS PI14/00290 and Ministerio de de Economía y Competitividad (PSI2011-28349)] and co-funded by Fondos Europeos de Desarrollo Regional (FEDER) funds - a way to build Europe. José C. Fernández-García is the recipient of a research contract from Servicio Andaluz de Salud (SAS) (B-0033-2014). CIBERobn and CIBERSAM are both initiatives of ISCIII.

Subjects
Anorexia Nervosa, Psychiatry and Psychology::Mental Disorders::Eating Disorders::Binge-Eating Disorder [Medical Subject Headings], Body water, Phenomena and Processes::Physiological Phenomena::Body Constitution::Body Weights and Measures::Body Mass Index [Medical Subject Headings], lcsh:Medicine, Índice de masa corporal, Anorexia nervosa, Metabolismo basal, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Fats, Impedancia eléctrica, adolescents, lcsh:Science, Psychiatry and Psychology::Mental Disorders::Eating Disorders::Anorexia Nervosa [Medical Subject Headings], eating-disorders, Body mass index, Metas, Multidisciplinary, Bulimia nervosa, Femenino, Anorèxia nerviosa, Trastorno por atracón, Modelos logísticos, Anatomy::Tissues::Connective Tissue::Adipose Tissue [Medical Subject Headings], Humanos, Treatment Outcome, Basal metabolic rate measurement, fat distribution, bioelectrical-impedance, Body Composition, Eating disorders, Obesitat, Female, women, medicine.symptom, Bioelectrical impedance analysis, Research Article, Adult, Tejido adiposo, medicine.medical_specialty, Patient Dropouts, weight-gain, water, Pes corporal, Anatomy::Fluids and Secretions::Body Fluids::Body Water [Medical Subject Headings], Anorexia nerviosa, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Motivation::Goals [Medical Subject Headings], Internal medicine, Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Outcome and Process Assessment (Health Care)::Outcome Assessment (Health Care)::Treatment Outcome [Medical Subject Headings], medicine, Treatment guidelines, Humans, Obesity, Composición corporal, Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Statistics as Topic::Models, Statistical::Logistic Models [Medical Subject Headings], Trastorns de la conducta alimentària, business.industry, lcsh:R, energy-expenditure, duration, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Techniques, Endocrine::Thyroid Function Tests::Basal Metabolism [Medical Subject Headings], Phenomena and Processes::Chemical Phenomena::Biochemical Phenomena::Body Composition [Medical Subject Headings], Body weight, medicine.disease, Agua corporal, Endocrinology, Check Tags::Female [Medical Subject Headings], Case-Control Studies, Basal metabolic rate, lcsh:Q, Resultado del tratamiento, Phenomena and Processes::Physical Phenomena::Magnetic Phenomena::Electromagnetic Phenomena::Electricity::Electric Conductivity::Electric Impedance [Medical Subject Headings], business, Weight gain
Abstract

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 pre-post 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. Instituto de Salud Carlos III [ISCIII] FIS PI11/00210 FIS PI14/00290 Fondos Europeos de Desarrollo Regional (FEDER) funds Servicio Andaluz de Salud (SAS) B-0033-2014 Instituto de Salud Carlos III [Ministerio de de Economia y Competitividad] PSI2011-28349

Published
2015

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