HIGH RESTING ENERGY-EXPENDITURE IN NORMAL-WEIGHT BULIMICS AND ITS NORMALIZATION WITH CONTROL OF EATING BEHAVIOR

Resting energy expenditure (REE) has been found to be lower in normal weight-bulimics (NWBs) than in controls and it was speculated that met abolic abnormalities might underlie bulimia. This study consisted of a longitudinal assessment of REE, body composition and energy intake be fore, during and after the control of eating behaviour, with compariso ns between REEs in NWBs, those in controls, and estimated basal energy expenditure (EBEE). NWBs in acute phase of bulimia were assessed the 1st, 2nd, and last day of a one-week hospitalization that warranted co mpliance with normal diet. Assessments were then repeated after a six- week outpatient psychotherapy. Mean REE in NWBs was higher than that i n controls and EBEE on admission. It decreased down to normal rate at discharge and at therapy termination. Fat-free mass (FFM) decreases sl ightly during hospitalization despite a weight-maintenance diet, but R EE-FFM ratio also decreased significantly. Metabolic factors which mig ht account for these results are discussed. Data suggest that: (1) cal oric requirements in NWBs were higher than estimated weight-maintenanc e rations; (2) binge-eating increased REE; (3) control of eating behav iour decreased REE. (C) 1996 Academic Press Limited