Dietary intake, nutritional status and energy metabolism in individuals with anorexia nervosa - Effects of specialized eating disorder hospital treatment

Abstract

Objective: Anorexia nervosa (AN) is a life-threatening condition affecting around 1% of the population. The aim of this thesis was to study nutritional aspects before and after specialized eating disorder hospital treatment of AN in adolescents and young adults. Methods: Data on 43 female patients was collected and used. Dietary intake was assessed by food records. Body composition was measured by dual energy X-ray absorptiometry (DXA) and resting energy expenditure by indirect calorimetry. Eating disorder symptoms were assessed by Eating Disorder Examination Questionnaire (EDE-Q) and Clinical Impairment Assessment (CIA). Gastrointestinal symptoms were assessed by Gastrointestinal Symptoms Rating Scale IBS (GSRS-IBS) and food related anxiety was measured using the Food Attitude Questionnaire. Results: Body weight increased by 22% and significant changes of improvement from admission to discharge were seen in body composition, energy expenditure, eating disorder symptoms, gastrointestinal symptoms and food related anxiety. At 3 year follow-up, 60% were recovered or in partial remission, 32% had very low energy intake, 85% had intakes below recommendations of iron, folate and vitamin D and subnormal values of body fat and skeletal muscle mass were present in 30% and 25%. Conclusions: Specialized eating disorder hospital treatment was successful regarding several nutritional aspects. Follow-up showed that 60% of young individuals with AN can reach full or partial symptom recovery, and that remission is possible also for patients with severe AN who need hospital treatment. Nutritional counseling is recommended during the whole treatment to reduce the risk of malnutrition in patients with anorexia nervosa. Keywords: Anorexia nervosa, body composition, skeletal muscle mass, energy intake, energy expenditure, gastrointestinal symptoms, food related anxiety