HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Van Wymelbeke, V. Articles by Rigaud, D. Search for Related Content PubMed PubMed Citation Articles by Van Wymelbeke, V. Articles by Rigaud, D. Agricola Articles by Van Wymelbeke, V. Articles by Rigaud, D.

Factors associated with the increase in resting energy expenditure during refeeding in malnourished anorexia nervosa patients^1,2,3

¹ From the Centre Européen des Sciences du Goût, Medical Research Unit-National Center of Scientific Research 5170, Dijon, France (VVW, LB, and DR), and the Service d'Endocrinologie, Le Bocage University Hospital, Dijon, France (DR and JMB)

Background: In malnourished anorexia nervosa (AN) patients, body-weight gain during refeeding is slowed by an increase in resting energy expenditure (REE).

Objective: The objective of the study was to identify factors associated with the increase in REE during refeeding.

Design: Before and 8, 30, and 45 d after the beginning of refeeding, REE was studied by indirect calorimetry in 87 female AN patients [ ± SD age: 23.4 ± 7.9 y; body mass index (in kg/m²) 13.2 ± 1.3]. Energy intake, body composition (by bioelectrical impedance analysis), physical activity, smoking behavior, abdominal pain, anxiety, depressive mood, serum thyrotropin and thyroid hormone, and urinary catecholamines were measured. REE was also evaluated in 18 patients after 1 y of recovery.

Results: By day 8, REE increased from 3.84 ± 0.6 to 4.36 ± 0.59 MJ/d (P < 0.01). This increase (13.4%) was significantly (P < 0.01) greater than that expected on the basis of the increase in fat-free mass (FFM; 1.6%). Thereafter, the ratio of REE to FFM remained high and, in multivariate analysis, was significantly related to 4 factors: energy intake (P < 0.01), anxiety (P < 0.01), abdominal pain (P < 0.05), and depressive mood (P < 0.05). The ratio also increased significantly with physical activity (P < 0.01) and cigarette smoking (P < 0.02). This rise in REE leveled off after recovery from AN.

Conclusion: In AN patients, the rise in REE observed during refeeding was independently linked to anxiety level, abdominal pain, physical activity, and cigarette smoking, and it contributed to resistance to weight gain.

Key Words: Energy expenditure • anorexia nervosa • malnutrition • anxiety • mood • depression • metabolism

This article has been cited by other articles:

				D. Rigaud, B. Verges, N. Colas-Linhart, A. Petiet, M. Moukkaddem, V. Van Wymelbeke, and L. Brondel Hormonal and Psychological Factors Linked to the Increased Thermic Effect of Food in Malnourished Fasting Anorexia Nervosa J. Clin. Endocrinol. Metab., May 1, 2007; 92(5): 1623 - 1629. [Abstract] [Full Text] [PDF]