CHANGES IN BODY-COMPOSITION AND FAT DISTRIBUTION AFTER SHORT-TERM WEIGHT-GAIN IN PATIENTS WITH ANOREXIA-NERVOSA

The most commonly described psychologic abnormality associated with an orexia nervosa is a distorted perception of body weight and shape. Thi s perception may contribute to the anorexic patient's resistance to ga ining weight even when it is a medical necessity. The purpose of this study was to assess body-composition and fat-distribution changes afte r short-term weight gain in 26 female anorexia nervosa patients 27.6 /- 6.6 ((x) over bar +/- SD) y of age, with a body mass index (BMI; in kg/m(2)) of 16.5 +/- 1.9. They participated in a refeeding protocol b oth as inpatients (n = 21) and as outpatients (n = 5) until they achie ved maximum weight gain. Body-composition and fat-distribution changes were measured by using dual-energy X-ray absorptiometry (DXA) and ski nfold thickness and circumference measurements. A mean weight gain of 6.7 +/- 5.3 kg (P < 0.001) was observed, which included significant in creases in body fat (P < 0.001), lean body mass (P < 0.05), and bone m ineral content (P < 0.01), with body fat being the component that incr eased the most. When measured by DXA, fat gain was not significantly d ifferent among the three central regions: subscapular, 1.7 +/- 1.2 kg; waist, 1.8 +/- 1.3 kg; and thigh, 1.5 +/- 1.0 kg (P = 0.10). Thus, al though fat was the largest component of the weight gained, there was n o preferential fat deposition in any one area and the female gynoid bo dy shape was maintained.