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Regional body composition in adolescents with anorexia nervosa and changes with weight recovery^2,3

¹ From the Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston (MM, KKM, SG, and AK); the Pediatric Endocrine Unit, MassGeneral Hospital for Children and Harvard Medical School, Boston (MM and LLL); and the Department of Pediatrics, University of Massachusetts Medical School, Worcester (LAS).

Background: Studies of regional fat distribution in adults with anorexia nervosa (AN) have shown decreased extremity fat at baseline and increased trunk fat with weight recovery, resulting in truncal adiposity. Little is known about fat distribution in adolescents with AN, especially with weight recovery.

Objective: We sought to determine whether regional fat distribution in adolescents with AN is comparable with that in healthy adolescents and whether weight recovery results in increased trunk fat and truncal adiposity.

Design: In 21 adolescent girls with AN and 21 control subjects matched for age and pubertal stage, we measured body-composition variables with dual-energy X-ray absorptiometry at baseline, 6 mo, and 12 mo. Weight recovery was defined as a ≥ 10% increase in body mass index.

Results: At baseline, the girls with AN had a lower percentage of trunk fat than did the control subjects, whereas the percentage of extremity fat was not significantly different between the groups. Weight recovery in 13 subjects with AN resulted in an increased percentage of trunk fat and an increased ratio of trunk fat to extremity fat; however, this ratio did not exceed that of control subjects.

Conclusions: In adolescents with AN, trunk fat rather than extremity fat is reduced. Weight recovery is associated with increased trunk fat and an increased ratio of trunk fat to extremity fat. In contrast with previous findings in adults, this most likely represents normalization of fat distribution rather than development of truncal adiposity.

Key Words: Anorexia nervosa • body composition • lean body mass • fat mass • trunk fat • extremity fat • adolescents • eating disorders

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