University of California, San Diego, California.
Drexel University, Philadelphia, Pennsylvania.
Int J Eat Disord. 2017 Apr;50(4):442-446. doi: 10.1002/eat.22697. Epub 2017 Mar 6.
Prior research suggests that both body mass index (BMI) and weight suppression (highest past weight minus current weight; WS) are important in determining adult anorexia nervosa (AN) severity. We examined associations between amenorrhea and WS, DSM-5 BMI severity category, and highest premorbid BMI among patients with AN.
Participants (N = 69) were adult female AN-spectrum patients at two residential treatment facilities. At admission, height, and weight were measured, and participants completed questionnaires assessing menstrual status and weight history.
Greater WS, adjusted for BMI, was associated with menstrual function at admission. First amenorrhea onset occurred at a normal BMI for 38.5% of participants. Premorbid highest BMI positively correlated with BMI at amenorrhea onset, and higher BMI at amenorrhea onset was associated with higher BMI at menses resumption.
These findings add to the literature indicating that relative and absolute weight status are dual indicators of illness severity in AN, and preliminarily suggest that a large proportion of adults who present for treatment initially may have shown symptoms of starvation at a normal BMI. Results underscore the need to focus on weight loss in early detection efforts and may inform target weight setting in the treatment of AN.
先前的研究表明，体重指数（BMI）和体重抑制（过去的最高体重减去当前体重；WS）在确定成年厌食症（AN）严重程度方面都很重要。我们研究了 AN 患者的闭经与 WS、DSM-5 BMI 严重程度类别和最高前驱 BMI 之间的关系。
参与者（N=69）为两家住院治疗机构的成年女性 AN 谱系患者。入院时测量身高和体重，参与者完成了评估月经状况和体重史的问卷。
调整 BMI 后，更大的 WS 与入院时的月经功能相关。38.5%的参与者首次闭经发生在正常 BMI 时。前驱期最高 BMI 与闭经时 BMI 呈正相关，闭经时 BMI 越高，恢复月经时 BMI 越高。
这些发现增加了文献中表明相对和绝对体重状态是 AN 疾病严重程度的双重指标的证据，并初步表明，最初接受治疗的大量成年人最初可能在正常 BMI 时就出现了饥饿症状。研究结果强调了在早期检测工作中关注体重减轻的必要性，并可能为 AN 的治疗中的目标体重设定提供信息。
