American Journal of Clinical Nutrition, Vol 65, 1034-1041, Copyright © 1997 by The American Society for Clinical Nutrition, Inc

ORIGINAL RESEARCH COMMUNICATIONS

Changes in body composition and fat distribution after short-term weight gain in patients with anorexia nervosa

CI Orphanidou, LJ McCargar, CL Birmingham and AS Belzberg
School of Family and Nutritional Sciences, University of British Columbia, Vancouver, Canada.

The most commonly described psychologic abnormality associated with anorexia nervosa is a distorted perception of body weight and shape. This perception may contribute to the anorexic patient's resistance to gaining weight even when it is a medical necessity. The purpose of this study was to assess body-composition and fat-distribution changes after short-term weight gain in 26 female anorexia nervosa patients 27.6 +/- 6.6 (mean +/- SD) y of age, with a body mass index (BMI; in kg/m2) of 16.5 +/- 1.9. They participated in a refeeding protocol both as inpatients (n = 21) and as outpatients (n = 5) until they achieved maximum weight gain. Body-composition and fat-distribution changes were measured by using dual-energy X-ray absorptiometry (DXA) and skinfold thickness and circumference measurements. A mean weight gain of 6.7 +/- 5.3 kg (P < 0.001) was observed, which included significant increases in body fat (P < 0.001), lean body mass (P < 0.05), and bone mineral content (P < 0.01), with body fat being the component that increased the most. When measured by DXA, fat gain was not significantly different among the three central regions: subscapular, 1.7 +/- 1.2 kg; waist, 1.8 +/- 1.3 kg; and thigh, 1.5 +/- 1.0 kg (P = 0.10). Thus, although fat was the largest component of the weight gained, there was no preferential fat deposition in any one area and the female gynoid body shape was maintained.

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