Anthropometry and Nutritional Rehabilitation in Underweight Eating Disorders

  • Giulio Marchesini
  • Laura Maria Ricciardi
  • Nicola Villanova
  • Riccardo Dalle Grave
Chapter

Abstract

The restoration of a normal body weight is a key strategy in the treatment of eating disorders, in order to eliminate the adverse effects of starvation on health and on the eating disorder psychopathology. Unfortunately, weight regain is frequently hindered by changes in body shape, in particular a protrusion of the abdomen, which may lead underweight patients to stop their nutritional rehabilitation program. In adult patients with underweight eating disorders, studies using dual-energy X-ray absorptiometry, skinfold thickness, dual photon absorptiometry and circumference measurements found a preferential accumulation of body fat in the central regions rather than the extremities during the process of weight regain. These data, however, were not confirmed in adolescents and in young adults with eating disorders. To date, the mechanism(s) implicated in the preferential accumulation of abdominal fat (e.g., low level of estrogens, fast rate of weight regain) have not been settled by experimental research, nor is it settled whether the preferential accumulation is a transient phenomenon or it persists after complete and stable weight restoration. Available data indicate that weight regain produces an increase in bone mineral density, initially greater in the hip than in the spine, but in the long-term bone recovery is never complete, especially whenever the eating disorder starts during adolescence and peak bone mass has not been attained. As lack of exercising may contribute to decrease bone mass, to increase the risk for atherosclerosis and to decrease compliance with the program, clinicians tend to incorporate healthy and social exercising in the nutritional rehabilitation. Preliminary findings indicate that this procedure helps patients get out of the isolation of their disease, overcome the urge to exercise, accept weight gain and changes in shape, and increase lean body mass, while it does not reduce the short-term gain of body fat or BMI.

Keywords

Obesity Depression Urea Estrogen Osteoporosis 

Abbreviations

AN

Anorexia nervosa

BIA

Bioelectric Impedance Analysis

BMC

Bone Mineral Content

BMD

Bone Mineral Density

BMI

Body Mass Index

DXA

Dual-Energy X-Ray Absorptiometry

DSM

Diagnostic and Statistical Manual of Mental Disorders

EDNOS

Eating Disorder Not Otherwise Specified

FM

Fat Mass

LBM

Lean body mass

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Giulio Marchesini
    • 1
  • Laura Maria Ricciardi
  • Nicola Villanova
  • Riccardo Dalle Grave
  1. 1.Clinical Dietetics“Alma Mater Studiorum” UniversityBolognaItaly

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