Metabolic and psychological changes during refeeding in anorexia nervosa.
OBJECTIVE
This study aimed to examine resting metabolic rate (RMR) and psychological changes during refeeding in 10 women with anorexia nervosa participating in a partial hospitalization eating disorder program.


RESULTS
Participants' admission RMRs, as assessed by the MedGem Analyzer, were below their RMRs predicted by the Harris- Benedict equation, t(1,9)=5.77, p<0.01. Correlational analyses revealed a trend toward smaller increases in RMR being associated with higher admission BMI (r=-0.49, p=0.08), but not with highest lifetime BMI. Over the course of treatment, RMR per pound of Fat-Free Mass (FFM) increased from the beginning to the middle, t(1,9)=-3.02, p<0.05, and to the end stage of treatment, t(1,9)=-2.53, p<0.05. Scores on the Eating Attitudes Test-26, Eating Disorder Inventory-2, Brief Symptom Inventory (BSI), BSI Depression subscale, and Mizes Anorectic Cognitions scale significantly improved throughout treatment (all p<0.05); however, body dissatisfaction did not improve.


CONCLUSIONS
Results suggest that weight restoration programs for anorexia nervosa cannot rely on FFM or standard formulas to predict caloric needs throughout refeeding, and that admission BMI is one factor to be considered in predicting caloric needs during refeeding. Furthermore, ways to improve body dissatisfaction during refeeding needs to be more of a treatment focus.
Konrad
K K
KK
Department of Psychology, Bowling Green State University, Bowling Green, OH 43403, USA. kkonrad@bgnet.bgsu.edu
Carels
R A
RA
Garner
D M
DM
D000273:Adipose Tissue; D000328:Adult; D000856:Anorexia Nervosa / Q000178:diet therapy / Q000378:metabolism* / Q000523:psychology*; D001481:Basal Metabolism; D001823:Body Composition; D001828:Body Image; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D006801:Humans; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D015430:Weight Gain