One-year weight follow-up in anorexia nervosa after inpatient psycho-nutritional rehabilitative treatment

Abstract

Many inpatient treatments have been proposed for anorexia nervosa (AN) in the past, but few weight outcomes are available today. The criteria for outcome evaluation have always considered body weight. The fifty-three women with AN [26 restrictive (ANR) and 27 bulimic (ANB), studied in this paper were all those discharged in 1996 after an inpatient psycho-nutritional rehabilitation programme. Body weight and BMI were significantly increased between admission and discharge and this increase was maintained at the one-year follow-up. Mean weight in ANR and ANB were similar both at admission and on discharge, but showed significant differences at the follow-up. Follow-up weight was stable (+/- 5%) in 31%, decreased in 15% and increased in 54% of ANR, compared with 44%, 33% and 23% respectively in ANB. There were no differences in age and illness duration. It is very difficult to study presence or absence of menses because many patients were on estro-progestins. Furthermore, only 28% of patients with menses presented BMI higher than 17.5. Only the ANR group showed a significant weight increase at the follow-up. Their BMI was acceptable in 65% compared with 33% in the ANB group. Bulimic behaviour seems to be itself a negative prognostic factor for weight recovery.