Adipose tissue distribution after weight restoration and weight maintenance in women with anorexia nervosa.
BACKGROUND
Body image distortions are a core feature of anorexia nervosa (AN). We, and others, previously reported abnormalities in adipose tissue distribution after acute weight restoration in adult women with AN compared with body mass index-matched healthy control women. Whether these abnormalities persist over time remains unknown.


OBJECTIVE
We aimed to 1) replicate previous findings that showed preferential central accumulation of adipose tissue in recently weight-restored AN women compared with control subjects, 2) describe the change within patients with longer-term (1-y) weight maintenance, and 3) compare adipose tissue distribution after 1-y maintenance with that of control subjects.


METHODS
Body composition and adipose tissue distribution were assessed by whole-body magnetic resonance imaging in women with AN shortly after weight normalization (n = 30) and again 1 y after hospital discharge (n = 16) and in 8 female control subjects at 2 time points.


RESULTS
With acute weight restoration, AN patients had significantly greater visceral and intermuscular adipose tissue compared with control women [visceral: 0.75 +/- 0.26 compared with 0.51 +/- 0.26 kg in AN patients and controls, respectively (P = 0.02); intermuscular: 0.46 +/- 0.17 compared with 0.29 +/- 0.13 kg in AN patients and controls, respectively (P = 0.01)]. With maintenance of normal weight for approximately 1 y, visceral adipose tissue distribution in AN patients was not different from that in healthy control subjects.


CONCLUSIONS
In adult women with AN, normalization of weight in the short term is associated with a distribution of adipose tissue that is consistent with a central adiposity phenotype. This abnormal distribution appears to normalize within a 1-y period of weight maintenance. This research was registered at clinicaltrials.gov as NCT 00271921 and NCT 00368667.
Mayer
Laurel E S
LE
Department of Psychiatry, Columbia University Medical Center, and New York State Psychiatric Institute, New York, NY, USA. lsm16@columbia.edu
Klein
Diane A
DA
Black
Elizabeth
E
Attia
Evelyn
E
Shen
Wei
W
Mao
Xiangling
X
Shungu
Dikoma C
DC
Punyanita
Mark
M
Gallagher
Dympna
D
Wang
Jack
J
Heymsfield
Steven B
SB
Hirsch
Joy
J
Ginsberg
Henry N
HN
Walsh
B Timothy
BT
D000273:Adipose Tissue / Q000033:anatomy & histology* / Q000502:physiology / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D000568:Amenorrhea / Q000209:etiology; D000856:Anorexia Nervosa / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D001823:Body Composition / Q000502:physiology; D001828:Body Image; D001835:Body Weight / Q000502:physiology*; D005239:Fear; D005260:Female; D006801:Humans; D008099:Liver / Q000033:anatomy & histology; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000033:anatomy & histology / Q000502:physiology / Q000503:physiopathology; D012016:Reference Values; D015430:Weight Gain; D055815:Young Adult