Lifetime Weight Characteristics of Adult Inpatients With Severe Anorexia Nervosa: Maximal Lifetime BMI Predicts Treatment Outcome.
Background: The body mass index is a key predictor of treatment outcome in patients with anorexia nervosa. In adolescents, higher premorbid BMI is a strong predictor of a favorable treatment outcome.
It is unclear whether this relationship holds true for adults with anorexia nervosa. Here, we examine adult patients with AN and investigate the lowest and highest lifetime BMI and weight suppression as predisposing factors for treatment outcome.
Methods: We included 107 patients aged 17-56 with anorexia nervosa and tracked their BMI from admission to inpatient treatment, through discharge, to follow-up at 1-6 years.
Illness history, including lowest and highest lifetime BMI, was assessed prior to admission. We used multiple linear regression models with minimal or maximal lifetime BMI or weight suppression at admission as independent variables to predict BMI at admission, discharge and, follow-up, while controlling for patients’ age, sex, and duration of illness.
Results: Low minimal BMI had a negative influence on the weight at admission, which in turn resulted in a lower BMI at discharge. Higher maximal BMI had a substantial positive influence on BMI at discharge and follow-up. Weight suppression was highly correlated with maximal BMI and showed similar effects to maximal BMI.
Conclusion: Our findings strongly support a relationship between low minimal lifetime BMI and lower BMI at admission, and between higher maximal lifetime BMI or weight suppression and a positive treatment outcome, even years after discharge.
Overall, maximal BMI emerged as the most important factor in predicting the weight course in adults with AN.
Keywords: anorexia nervosa; hospitalization; treatment outcome; weight characteristics; weight suppression. PMID: 34335330 PMCID: PMC8319499 DOI: 10.3389/fpsyt.2021.682952. Front Psychiatry. 2021 Jul 15;12:682952. doi: 10.3389/fpsyt.2021.682952. eCollection 2021.