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Altered energy metabolism in anorexia nervosa
J Russell1, L A Baur, P J Beumont
1Department of Psychological Medicine, University of Sydney, NSW 2006, Sydney, Australia. jrussell1@mail.usyd.edu.au
Psychoneuroendocrinology
|November 9, 2000
Summary
Patients with anorexia nervosa exhibit energy wasting, characterized by low resting energy expenditure and high diet-induced thermogenesis early in refeeding. This suggests biological repair processes may impede full restoration of fat stores.
Area of Science:
- Metabolic research
- Clinical nutrition
- Eating disorder research
Background:
- Optimal nutritional rehabilitation for anorexia nervosa necessitates a clearer understanding of energy and substrate requirements.
- Indirect calorimetry is a key tool for assessing metabolic states in clinical populations.
Purpose of the Study:
- To investigate energy expenditure and substrate utilization in female patients with anorexia nervosa during nutritional rehabilitation.
- To compare metabolic parameters between underweight, refeeding, and healthy individuals.
Main Methods:
- Indirect calorimetry was used to measure resting energy expenditure (REE) and respiratory quotient (RQ) in fasting and post-glucose states.
- Measurements were taken in anorexia nervosa patients pre-refeeding and at discharge, alongside healthy controls.
Main Results:
- Pre-refeeding patients showed a high basal RQ and low REE, with paradoxically higher diet-induced thermogenesis (DIT) compared to post-refeeding patients and controls.
- Post-glucose RQ exceeded unity in pre-refeeding patients, indicating net lipogenesis, while post-refeeding patients' RQ normalized, suggesting curtailed lipogenesis.
Conclusions:
- Emaciated anorexia nervosa patients exhibit significant energy wasting.
- Early refeeding may involve disproportionate energy loss due to biological repair, with potential later impediments to fat store restoration.