title: Changes in Body Composition in Anorexia Nervosa: Predictors of Recovery and Treatment Outcome.
abstract: The restoration of body composition (BC) parameters is considered to be one of the most important goals in the treatment of patients with anorexia nervosa (AN). However, little is known about differences between AN diagnostic subtypes [restricting (AN-R) and binge/purging (AN-BP)] and weekly changes in BC during refeeding treatment. Therefore, the main objectives of our study were twofold: 1) to assess the changes in BC throughout nutritional treatment in an AN sample and 2) to analyze predictors of BC changes during treatment, as well as predictors of treatment outcome. The whole sample comprised 261 participants [118 adult females with AN (70 AN-R vs. 48 AN-BP), and 143 healthy controls]. BC was measured weekly during 15 weeks of day-hospital treatment using bioelectrical impedance analysis (BIA). Assessment measures also included the Eating Disorders Inventory-2, as well as a number of other clinical indices. Overall, the results showed that AN-R and AN-BP patients statistically differed in all BC measures at admission. However, no significant time×group interaction was found for almost all BC parameters. Significant time×group interactions were only found for basal metabolic rate (p = .041) and body mass index (BMI) (p = .035). Multiple regression models showed that the best predictors of pre-post changes in BC parameters (namely fat-free mass, muscular mass, total body water and BMI) were the baseline values of BC parameters. Stepwise predictive logistic regressions showed that only BMI and age were significantly associated with outcome, but not with the percentage of body fat. In conclusion, these data suggest that although AN patients tended to restore all BC parameters during nutritional treatment, only AN-BP patients obtained the same fat mass values as healthy controls. Put succinctly, the best predictors of changes in BC were baseline BC values, which did not, however, seem to influence treatment outcome.
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.|CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.
authors.forename: Zaida
authors.initials: Z
authors.lastname: Agüera
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.
authors.forename: Xandra
authors.initials: X
authors.lastname: Romero
authors.affiliation: Loughborough University Centre for Research into Eating Disorders, Loughborough University, Loughborough, United Kingdom.
authors.forename: Jon
authors.initials: J
authors.lastname: Arcelus
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Sánchez
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.
authors.forename: Nadine
authors.initials: N
authors.lastname: Riesco
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.|CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.|Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Jiménez-Murcia
authors.affiliation: Marqués de Valdecilla Public Foundation-Research Institute (FMV-IFIMAV), Santander, Spain.
authors.forename: Jana
authors.initials: J
authors.lastname: González-Gómez
authors.affiliation: CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.|Department of Psychobiology and Methodology, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Roser
authors.initials: R
authors.lastname: Granero
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Custal
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.|Dietetics and Nutrition Unit, University Hospital of Bellvitge, Barcelona, Spain.
authors.forename: Monica
authors.initials: M
authors.lastname: Montserrat-Gil de Bernabé
authors.affiliation: Department of Psychobiology and Methodology, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Salomé
authors.initials: S
authors.lastname: Tárrega
authors.affiliation: CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.|Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain.
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Baños
authors.affiliation: CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.|Department of Basic Psychology, Clinic and Psychobiology, University Jaume I, Castelló, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Botella
authors.affiliation: CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.|Human Pharmacology and Clinical Neurosciences Research Group, Neuroscience Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: de la Torre
authors.affiliation: CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.|Department of Diabetes, Endocrinology and Nutrition, Hospital Clínico Universitario Virgen de Victoria, Málaga, Spain.
authors.forename: José C
authors.initials: JC
authors.lastname: Fernández-García
authors.affiliation: CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.|Department of Diabetes, Endocrinology and Nutrition, Institut d'Investigació Biomèdica de Girona (IdlBGi) Hospital Dr Josep Trueta, Girona, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Fernández-Real
authors.affiliation: CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.|Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain.
authors.forename: Gema
authors.initials: G
authors.lastname: Frühbeck
authors.affiliation: CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.|Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Gómez-Ambrosi
authors.affiliation: CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.|Department of Diabetes, Endocrinology and Nutrition, Hospital Clínico Universitario Virgen de Victoria, Málaga, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Tinahones
authors.affiliation: CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.|Endocrine Division, Complejo Hospitalario U. de Santiago, Santiago de Compostela, Spain.
authors.forename: Ana B
authors.initials: AB
authors.lastname: Crujeiras
authors.affiliation: CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.|Endocrine Division, Complejo Hospitalario U. de Santiago, Santiago de Compostela, Spain.
authors.forename: Felipe F
authors.initials: FF
authors.lastname: Casanueva
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.|Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.|CIBER de Salud Mental (CIBERSAM), Barcelona, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Menchón
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.|CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.|Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Fernández-Aranda
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000503:physiopathology* / Q000628:therapy*; D001823:Body Composition; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D010352:Patient Dropouts; D016896:Treatment Outcome