Mayer, L., et al. - The goal of this study was to investigate the relationship of body composition and neuroendocrine levels with clinical outcome in women with Anorexia Nervosa in a relapse-prevention trial…
METHOD: Body composition and fasting cortisol and leptin levels were assessed before random assignment in 32 weight-recovered subjects with Anorexia Nervosa from the New York site of the Fluoxetine to Prevent Relapse in Women With Anorexia Nervosa trial. Clinical outcome at the end of study participation was defined using modified Morgan-Russell criteria (full, good, fair, poor), then dichotomized into treatment “success” or “failure.”
RESULTS: In a binary logistic regression model examining the effect of percent body fat, body mass index, Anorexia Nervosa subtype, waist-to-hip ratio, and serum cortisol and leptin levels on treatment outcome, only percent body fat was significantly associated with outcome.
Relapse is a significant problem for individuals with Anorexia Nervosa, with relapse rates as high as 50%. Identification of predictors of relapse is a critical step in recognizing patients at increased risk for relapse and developing more successful treatment interventions. Persistent and excessive body image disturbances have been identified as potential psychological risk factors increasing the likelihood of relapse, but few studies have explored potential neurobiological risk factors for relapse. The role of body mass index has been examined, and studies have suggested that a higher body mass index at presentation for treatment is associated with better long-term outcome. Leptin levels following partial weight restoration have been inversely associated with relapse at 1-year follow-up. Despite the psychological fear of fat and weight gain that characterizes Anorexia Nervosa, to our knowledge, there are no published studies of body composition as a predictor of relapse.
This study aimed to investigate the relationship between body composition, hormones, and clinical outcome in a cohort of women with Anorexia Nervosa participating in a relapse-prevention study and a longitudinal study of body composition in Anorexia Nervosa.
Conclusion: In recently weight-restored women with Anorexia Nervosa, lower percent body fat was associated with poor long-term outcome [more...]
American Journal of Psychiatry
