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. 2022 May 20;12(5):836.
doi: 10.3390/jpm12050836.

BMI at Discharge from Treatment Predicts Relapse in Anorexia Nervosa: A Systematic Scoping Review

Stein Frostad  1 , Natalia Rozakou-Soumalia  2 , Ştefana Dârvariu  2 , Bahareh Foruzesh  2 , Helia Azkia  2 , Malina Ploug Larsen  2 , Ehsan Rowshandel  2 , Jan Magnus Sjögren  2   3
Affiliations

BMI at Discharge from Treatment Predicts Relapse in Anorexia Nervosa: A Systematic Scoping Review

Stein Frostad et al. J Pers Med. .

Abstract

Background: Anorexia nervosa (AN) has high rates of enduring disease and mortality. Currently, there is insufficient knowledge on the predictors of relapse after weight normalization and this is why a systematic literature review was performed.

Methods: PubMed, EMBASE, PsychInfo, and Cochrane databases were searched for literature published until 13 July 2021. All study designs were eligible for inclusion if they focused on predictors of relapse after weight normalization in AN. Individual study definitions of relapse were used, and in general, this was either a drop in BMI and/or reccurrence of AN symptoms.

Results: The database search identified 11,507 publications, leaving 9511 publications after the removal of duplicates and after a review of abstracts and titles; 191 were selected for full-text review. Nineteen publications met the criteria and included 1398 AN patients and 39 healthy controls (HC) from adults and adolescents (ages range 11-73 years). The majority used a prospective observational study design (12 studies), a few used a retrospective observational design (6 studies), and only one was a non-randomized control trial (NRCT). Sample sizes ranged from 16 to 191 participants. BMI or measures of body fat and leptin levels at discharge were the strongest predictors of relapse with an approximate relapse rate of 50% at 12 months. Other predictors included signs of eating disorder psychopathology at discharge.

Conclusions: BMI at the end of treatment is a predictor of relapse in AN, which is why treatment should target a BMI well above 20. Together with the time to relapse, these outcomes are important to include in the evaluation of current and novel treatments in AN and for benchmarking.

Keywords: anorexia nervosa; eating disorders; predictor; relapse; systematic review; weight gain.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Prisma flow diagram of study screening and inclusion.
Figure 2
Figure 2
Risk of bias assessment for every individual study.
See this image and copyright information in PMC

References

    1. American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Publishing; Washington, DC, USA: 2013.
    1. Lock J. Updates on Treatments for Adolescent Anorexia Nervosa. Child Adolesc. Psychiatr. Clin. N. Am. 2019;28:523–535. doi: 10.1016/j.chc.2019.05.001. - DOI - PubMed
    1. Dalle Grave R., Sartirana M., Sermattei S., Calugi S. Treatment of Eating Disorders in Adults Versus Adolescents: Similarities and Differences. Clin. Ther. 2020;43:70–84. doi: 10.1016/j.clinthera.2020.10.015. - DOI - PubMed
    1. Eating Disorders: Recognition and treatment. National Institute for Health and Care Excellence, London. 2017. [(accessed on 18 May 2020)]. Available online: https://www.nice.org.uk/guidance/ng69. - PubMed
    1. Mitchell J.E., Peterson C.B. Anorexia Nervosa. N. Engl. J. Med. 2020;382:1343–1351. doi: 10.1056/NEJMcp1803175. - DOI - PubMed

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