Associations between low body weight, weight loss, and medical instability in adults with eating disorders

International Journal of Eating Disorders
By Dennis Gibson, MD, FACP, CEDS Vishnupriya "Priya" Khatri, MD Delaney Wesselink, PT, DPT, CEDS Philip S. Mehler, MD, FACP, FAED, CEDS

Abstract

Objective: The physical complications of atypical anorexia nervosa remain understudied, with most studies completed in adolescents. This study seeks to examine the impact of various weight measures as predictors of medical instability in a large cohort of adult eating disorder patients.

Methods: In this retrospective cohort study, the impact of admission body mass index (BMI), weight suppression, and recent weight loss (the rate of weight loss within the last 12 months) toward the development of medical complications of malnutrition were examined. Multivariable logistic regression assessed the association of binary clinical outcomes of interest with recent weight loss and weight suppression (adjusting for age, admission BMI, gender, and purging behaviors). Odds ratios (OR) and 99% confidence intervals were reported.

Results: Greater recent weight loss increased the odds of developing low prealbumin and reduced hand grip strength. A greater weight suppression was associated with increased likelihood of amenorrhea, reduced systolic blood pressure, nadir hemoglobin, and weekly weight gain upon nutritional rehabilitation. Lower admission BMI was predictive of all the medical outcomes examined, with the exception of bradycardia, and was generally the strongest predictor based on standardized coefficients.

DOI:
https://doi.org/10.1002/eat.24129
Written by
dennis gibson

Dennis Gibson, MD, FACP, CEDS

Dennis Gibson, MD, FACP, CEDS serves as the Clinical Operations Director at ACUTE. Dr. Gibson joined ACUTE in 2017 and has since dedicated his clinical efforts to the life-saving medical care of…
Written by
vishnupriya khatri

Vishnupriya "Priya" Khatri, MD

Dr. Priya Khatri joined the ACUTE Center for Eating Disorders & Severe Malnutrition in 2019 as a Hospitalist. Dr. Priya Khatri joined the ACUTE team in 2019. She finds working with a dedicated…
Written by
Delaney Frazier

Delaney Wesselink, PT, DPT, CEDS

Originally from Boise, Idaho, Delaney received her BS in Exercise Science at the University of Montana in Missoula, MT. Expanding upon her love for the mountains, she pursued her Doctorate in Physical…
Written by
Philip S. Mehler, MD, FACP, FAED, CEDS

Philip S. Mehler, MD, FACP, FAED, CEDS

Dr. Philip S. Mehler began his career at Denver Health more than 35 years ago and was formerly its Chief of Internal Medicine and then Denver Health’s Chief Medical Officer (CMO) until he was promoted…

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