Interrelationships between the size of the pancreas and the weight of patients with eating disorders

Objective: Starvation severely affects normal pancreatic function in childr en suffering from Kwashiorkor and in animals undergoing food deprivation. T his study examines whether pancreatic size, as determined by ultrasound, is dependent on starvation or on eating patterns in patients with eating diso rders. Method: In 109 inpatients with eating disorders, 86 with anorexia ne rvosa and 23 with bulimia nervosa, we determined the pancreatic size by mea ns of abdominal ultrasonography before increase in weight. Twenty-four inpa tients with other psychiatric disorders served as controls. Pancreatic size was defined by the maximal diameter and the length of the head, the diamet er of the head at the confluence of the splenic and mesenteric veins, and t he diameters of the body and tail. In 41 eating disorder patients, pancreat ic size was also measured during the course of therapy and increase in weig ht. Results: Pancreatic size correlates highly with body mass index (BMI). Counteracting actions such as purging do not seem to influence this pathoph ysiologic finding. Dystrophy of the pancreas is reversible in a short perio d of time. The increase in pancreatic size after maintenance of a normal ea ting pattern, however, exceeded the size expected by regression equation wi th an increase in the BMI. Pancreatic size seems to correlate with the actu al amount of digested food. The increase in BMI is only an indicator of foo d intake. Discussion: Pancreatic size might therefore be useful for the ass essment of normalization of the eating pattern. Future research is necessar y to investigate the impairment of pancreatic function resulting from dystr ophy, the impact of possible pancreatic malfunction on the course of eating disorders, and the regulatory mechanisms responsible for the change of pan creatic size. (C) 2000 by John Wiley & Sons, Inc.