2 EFFECTS OF REFEEDING ON BODY HABITUS IN MALNOURISHED ADOLESCENTS WITH ANOREXIA NERVOSA

Abstract

Weight gain is one of the therapeutic goals for adolescents with anorexia nervosa. The quality of such weight gain in terms of tissue deposition has not been studied. We determined the distribution of weight gain between fat and muscle tissue upon refeeding. Percent body fat (from skin fold thickness), % muscle mass (from creatinine excretion) and muscular development (from corrected upper arm diameter) were obtained on 6 malnourished teenagers initially and upon refeeding. Subjects (5 female, 1 male) ranged in age from 13-19 years (x=15); average weight gain was 5.9 ± 1.3(SE) kg. Two pts., who were the most wasted and gained the most weight (43% and 23% of initial weight, respectively) put on a disproportionate amount of body fat (285,263%). The % muscle mass and upper arm diameter remained essentially constant and considerably below normal for age/sex. The remaining 4 pts. increased their body weight by 8-12% and gained both muscle and fat in similar proportions: the % body fat increased by 27 ± 6 (SE)% and muscle mass by 20 ± 7%. Muscular development calculated from the square of the increment in upper arm diameter increased by 16 ± 4%.

We conclude that there are at least two patterns of weight gain with refeeding. Pts. who were extremely malnourished with severe fat and muscle wasting gained a disproportionate amount of fat, while those who were less malnourished gained by the accretion of similar amounts of fat and muscle. Reasons for the observed differences may relate to variations in fat and muscle wasting, diet, habitus, and type and amount of exercise. Therapeutic goals should consider the quality, as well as quantity, of weight gain achieved during refeeding.

Log in or create a free account to read this content

Gain free access to this article, as well as selected content from this journal and more on nature.com

Access through your institution

or

Sign in or create an account

Continue with Google

Continue with ORCiD