Neuroscience Department, Psychiatry Unit, University of Padua, Padua, Italy.
Psychiatry Unit, Padua University Hospital, Padua, Italy.
Int J Eat Disord. 2018 Jun;51(6):542-548. doi: 10.1002/eat.22861. Epub 2018 Mar 30.
Growing evidence suggests an impact of weight suppression (WS) on severity and course of symptoms in patients with eating disorders (ED), but no study explored also the role of the weight loss speed (WLS) together with WS on the same clinical variables, which is the aim of the present work.
A mixed cross-sectional and longitudinal cohort study was employed. Four hundred and fourteen patients with anorexia nervosa (AN = 208) or bulimia nervosa (BN = 206) according to DSM-5 criteria were recruited and assessed at referral by means of clinical interviews and self-reported questionnaires. Body mass index and diagnostic status were re-evaluated at the end of treatment.
WS was positively correlated with body dissatisfaction in patients with AN (p = .005), but negatively correlated in BN (p = .022). In contrast, WLS was significantly inversely correlated with age and duration of illness in all ED (p < .001), and positively correlated with drive for thinness in BN (p = .007). After treatment, WS at intake predicted higher BMI increase in both AN and BN (p < .03), while higher WLS was significantly associated with a lower drop-out rate in patients with BN (p = .02), and predicted BMI increase only in restricting AN patients (p = .02). In the whole group, WLS significantly predicted remission status (p = .039).
In our study, both WS and WLS were associated with baseline "core" clinical variables and provided complementary abilities to predict weight gain and remission at the end of treatment. If replicated, our data suggest the importance of considering both WS and WLS as useful clinical variables in the baseline assessment of ED.
越来越多的证据表明，体重抑制（WS）对饮食失调（ED）患者的症状严重程度和病程有影响，但尚无研究同时探讨 WS 与体重减轻速度（WLS）对相同临床变量的作用，本研究旨在探讨这一问题。
采用混合横断面和纵向队列研究。根据 DSM-5 标准，共招募了 414 名神经性厌食症（AN=208）或神经性贪食症（BN=206）患者，并在就诊时通过临床访谈和自我报告问卷进行评估。在治疗结束时重新评估体重指数和诊断状况。
WS 与 AN 患者的身体不满呈正相关（p=0.005），但与 BN 患者呈负相关（p=0.022）。相比之下，WLS 与所有 ED 患者的年龄和疾病持续时间呈显著负相关（p<0.001），与 BN 患者的瘦欲呈正相关（p=0.007）。治疗后，摄入时的 WS 预测 AN 和 BN 患者的 BMI 增加更高（p<0.03），而较高的 WLS 与 BN 患者的较低辍学率显著相关（p=0.02），并仅预测限制型 AN 患者的 BMI 增加（p=0.02）。在整个组中，WLS 显著预测缓解状态（p=0.039）。
在我们的研究中，WS 和 WLS 均与基线“核心”临床变量相关，并提供了补充能力来预测治疗结束时的体重增加和缓解。如果得到复制，我们的数据表明，在 ED 的基线评估中，考虑 WS 和 WLS 作为有用的临床变量非常重要。
