Metabolic and psychological changes during refeeding in anorexia nervosa

This study aimed to examine resting metabolic rate (RMR) and psychological changes during refeeding in 10 women with anorexia nervosa participating in a partial hospitalization eating disorder program.

Participants' admission RMRs, as assessed by the MedGem Analyzer, were below their RMRs predicted by the Harris- Benedict equation, t(1,9)=5.77, p<0.01. Correlational analyses revealed a trend toward smaller increases in RMR being associated with higher admission BMI (r=-0.49, p=0.08), but not with highest lifetime BMI. Over the course of treatment, RMR per pound of Fat-Free Mass (FFM) increased from the beginning to the middle, t(1,9)=-3.02, p<0.05, and to the end stage of treatment, t(1,9)=-2.53, p<0.05. Scores on the Eating Attitudes Test-26, Eating Disorder Inventory-2, Brief Symptom Inventory (BSI), BSI Depression subscale, and Mizes Anorectic Cognitions scale significantly improved throughout treatment (all p<0.05); however, body dissatisfaction did not improve.

Results suggest that weight restoration programs for anorexia nervosa cannot rely on FFM or standard formulas to predict caloric needs throughout refeeding, and that admission BMI is one factor to be considered in predicting caloric needs during refeeding. Furthermore, ways to improve body dissatisfaction during refeeding needs to be more of a treatment focus.