title: Body fat redistribution after weight gain in women with anorexia nervosa.
abstract: BACKGROUND
  Body image distortions are a core feature of anorexia nervosa (AN). Increasing evidence suggests that the fat distribution immediately after weight restoration in patients with AN differs from the distribution typical of healthy adult women.
  
  
  OBJECTIVE
  The purpose of this study was to assess body fat distribution before and shortly after normalization of weight in women with AN.
  
  
  METHODS
  Body composition and fat distribution were assessed by anthropometry, dual-energy X-ray absorptiometry, and whole-body magnetic resonance imaging in 29 women with AN before and after weight normalization and at a single time point in 15 female control subjects. Hormone concentrations were also evaluated in patients and control subjects.
  
  
  RESULTS
  During approximately 10.1 +/- 2.9 wk (range: 4-17.3 wk) of treatment, patients with AN gained 12.2 +/- 3.6 kg, and refed weight (54.1 +/- 4.2 kg) did not differ significantly from that of control subjects (54.7 +/- 4.4 kg). Waist-to-hip circumference ratio (P < 0.006), total trunk fat (P < 0.003), visceral adipose tissue (P < 0.006), and intramuscular adipose tissue (P < 0.003) were significantly greater in the weight-recovered patients than in the control subjects. In contrast, after refeeding, total subcutaneous adipose tissue and skeletal muscle mass did not differ significantly between the patients and control subjects. In patients with AN, serum cortisol decreased and serum estradiol increased significantly with refeeding but not to control concentrations.
  
  
  CONCLUSIONS
  In women with AN, normalization of weight in the short term is associated with an abnormal distribution of body fat. The implications of these findings for the long-term psychological and physical health of women with AN are unknown.
authors.affiliation: Department of Psychiatry, Columbia University, New York, NY, USA. lsm16@columbia.edu
authors.forename: Laurel
authors.initials: L
authors.lastname: Mayer
authors.forename: B Timothy
authors.initials: BT
authors.lastname: Walsh
authors.forename: Richard N
authors.initials: RN
authors.lastname: Pierson
authors.forename: Steven B
authors.initials: SB
authors.lastname: Heymsfield
authors.forename: Dympna
authors.initials: D
authors.lastname: Gallagher
authors.forename: Jack
authors.initials: J
authors.lastname: Wang
authors.forename: Michael K
authors.initials: MK
authors.lastname: Parides
authors.forename: Rudolph L
authors.initials: RL
authors.lastname: Leibel
authors.forename: Michelle P
authors.initials: MP
authors.lastname: Warren
authors.forename: Erin
authors.initials: E
authors.lastname: Killory
authors.forename: Deborah
authors.initials: D
authors.lastname: Glasofer
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000254:growth & development*; D000328:Adult; D000856:Anorexia Nervosa / Q000097:blood / Q000503:physiopathology* / Q000628:therapy; D000886:Anthropometry; D001823:Body Composition / Q000502:physiology*; D016022:Case-Control Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013997:Time Factors; D015430:Weight Gain / Q000502:physiology*
chemical_list: D004958:Estradiol; D006854:Hydrocortisone