Body fat distribution before and after weight gain in anorexia nervosa

OBJECTIVE: To study abdominal fat distribution in anorexia nervosa subjects and to assess the effects of initial weight regain on abdominal fat distribution.DESIGN: Longitudinal, clinical study. The baseline measurement was acquired within four days of admission to the eating disorders clinic. All patients were treated by re-feeding, reinforced by psychotherapy. Following weight regain of at least 5 kg, a second body fat distribution evaluation was performed. Of the 21 subjects evaluated at baseline, 14 achieved the goal of body weight regain and were retested.PATIENTS: Fourteen subjects (age: 18-38 y; body mass index: 11.5-18.3; relative body weight: 54.9-88.3%).MEASUREMENTS: Total, subcutaneous and visceral abdominal adipose tissue areas at the L4-L5 level were evaluated by competed tomography.RESULTS: At baseline the subjects showed a higher proportion of visceral adipose tissue (% visceral adipose tissue = 55.3+/-26.1). A significant association was observed between body weight and both subcutaneous adipose tissue and total adipose tissue. A regain of body weight of 7.3+/-1.6 kg was accompanied by a significant increase in total adipose tissue, comprising both subcutaneous and visceral adipose tissue. The increase observed in subcutaneous adipose tissue, however, was significantly greater than for visceral adipose tissue (212.6% vs 116.8%, respectively, P<0.01).CONCLUSION: The results of the current study show a higher proportion of visceral adipose tissue than subcutaneous adipose tissue in anorexia nervosa subjects. With regain of body weight there is a preferential regain of subcutaneous adipose tissue. These data demonstrate a redistribution of abdominal adipose tissue with weight regain in anorexia nervosa subjects.