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Weight gain and nutritional efficacy in anorexia nervosa.

Abstract

To evaluate the usefulness of interval weight change in assessing nutritional support efficacy, we studied four anorexia nervosa patients (52% ideal body weight) requiring long-term total parenteral nutrition (TPN) for 63 +/- 18 days. Fluid and electrolyte deficits were corrected before the initiation of nutritional support. Resting energy expenditure was measured before the initiation of TPN and weekly thereafter, using indirect calorimetry. Daily caloric expenditure was estimated at 1.1 X resting energy expenditure, based on previous studies of continuous heart rate monitoring in this patient population. Daily excess calories were calculated as caloric intake minus caloric expenditure. Each patient was weighed daily and linear regression analysis (excess calories versus weight change) was performed for individual patients and the group over intervals of varying length. There was no individual or group correlation between excess calories and weight gain on a daily or weekly interval basis. Cumulative weight changes over the long-term course of TPN correlated significantly with cumulative excess calories for each patient and the whole group (r = +0.82, p less than 0.01). The excess calories required to gain a kilogram body weight ranged from 5569 to 15619 kcal/kg with a mean of 9768. Cumulative long-term weight changes during nutritional repletion in anorexia nervosa are meaningful indicators of caloric balance, but short interval weight changes (daily, weekly) are not. The caloric cost of weight gain is variable in this population.

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  • Authors

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    MeSH

    Adolescent
    Adult
    Anorexia Nervosa
    Body Weight
    Energy Intake
    Energy Metabolism
    Female
    Humans
    Male
    Parenteral Nutrition
    Parenteral Nutrition, Total

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    6421142

    Citation

    Dempsey, D T., et al. "Weight Gain and Nutritional Efficacy in Anorexia Nervosa." The American Journal of Clinical Nutrition, vol. 39, no. 2, 1984, pp. 236-42.
    Dempsey DT, Crosby LO, Pertschuk MJ, et al. Weight gain and nutritional efficacy in anorexia nervosa. Am J Clin Nutr. 1984;39(2):236-42.
    Dempsey, D. T., Crosby, L. O., Pertschuk, M. J., Feurer, I. D., Buzby, G. P., & Mullen, J. L. (1984). Weight gain and nutritional efficacy in anorexia nervosa. The American Journal of Clinical Nutrition, 39(2), pp. 236-42.
    Dempsey DT, et al. Weight Gain and Nutritional Efficacy in Anorexia Nervosa. Am J Clin Nutr. 1984;39(2):236-42. PubMed PMID: 6421142.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Weight gain and nutritional efficacy in anorexia nervosa. AU - Dempsey,D T, AU - Crosby,L O, AU - Pertschuk,M J, AU - Feurer,I D, AU - Buzby,G P, AU - Mullen,J L, PY - 1984/2/1/pubmed PY - 1984/2/1/medline PY - 1984/2/1/entrez SP - 236 EP - 42 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 39 IS - 2 N2 - To evaluate the usefulness of interval weight change in assessing nutritional support efficacy, we studied four anorexia nervosa patients (52% ideal body weight) requiring long-term total parenteral nutrition (TPN) for 63 +/- 18 days. Fluid and electrolyte deficits were corrected before the initiation of nutritional support. Resting energy expenditure was measured before the initiation of TPN and weekly thereafter, using indirect calorimetry. Daily caloric expenditure was estimated at 1.1 X resting energy expenditure, based on previous studies of continuous heart rate monitoring in this patient population. Daily excess calories were calculated as caloric intake minus caloric expenditure. Each patient was weighed daily and linear regression analysis (excess calories versus weight change) was performed for individual patients and the group over intervals of varying length. There was no individual or group correlation between excess calories and weight gain on a daily or weekly interval basis. Cumulative weight changes over the long-term course of TPN correlated significantly with cumulative excess calories for each patient and the whole group (r = +0.82, p less than 0.01). The excess calories required to gain a kilogram body weight ranged from 5569 to 15619 kcal/kg with a mean of 9768. Cumulative long-term weight changes during nutritional repletion in anorexia nervosa are meaningful indicators of caloric balance, but short interval weight changes (daily, weekly) are not. The caloric cost of weight gain is variable in this population. SN - 0002-9165 UR - https://www.unboundmedicine.com/medline/citation/6421142/Weight_gain_and_nutritional_efficacy_in_anorexia_nervosa_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/39.2.236 DB - PRIME DP - Unbound Medicine ER -