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Anorexia nervosa in adolescents: evolution of weight history and impact of excess premorbid weight

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Abstract

The purpose of our study is to establish if the proportion of patients diagnosed with anorexia nervosa that have a history of excess weight has increased over a 10-year period and to study how different premorbid weight groups vary in terms of clinical characteristics. We performed a single-center, retrospective cohort study of all new patients presenting with anorexia nervosa, restrictive and binge/purge subtypes, in 2004 and 2014 at the Adolescent Medicine Clinic of Sainte-Justine University Health Centre (n = 172). The prevalence of excess premorbid weight was similar in both cohorts (32% in 2004 versus 29.5% in 2014). The historically overweight subgroup had a lower heart rate at intake (64.77 versus 69.75, p = 0.03). Patients with excess premorbid weight lost an average of 1 kg more per month than their historically thinner counterparts (2.6 kg versus 1.6 kg/month, p = 0.0011). The total decrease in BMI was much greater in patients with a history of excess weight (7 BMI points versus 3.8, p = 0.0001).

Conclusion: Since overweight and obese patients present with significant weight suppression values, our study stresses the importance of screening for AN in all patients rather than in only the noticeably underweight.

What is Known:

• More than one third of patients presenting with AN have a history of overweight or obesity, which is comparable to the general population.

• A delay between AN onset and diagnosis has been described in overweight adolescents.

What is New:

• Historically overweight patients presenting with AN demonstrate increased speed of weight loss, greater drop in BMI, and lower heart rate at presentation.

• For patients with a history of excess weight considered as having recovered from AN, the average BMI at discharge was within normal limits.

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Abbreviations

AN:

Anorexia nervosa

BMI:

Body mass index

SD:

Standard deviation

NS:

Non-significant

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Author notes

  1. Klara Meierer and Alexandre Hudon contributed equally to this work.

Authors and Affiliations

  1. University of Montreal, 2900 Boulevard Edouard-Montpetit, Montreal, Quebec, H3T 1J4, Canada

    Klara Meierer, Alexandre Hudon, Marie-France Leduc, Danielle Taddeo, Olivier Jamoulle, Jean-Yves Frappier & Chantal Stheneur

  2. Department of Pediatrics, Ambroise Paré Hospital, 9 Avenue Charles de Gaulle, 92100, Boulogne-Billancourt, France

    Marc Sznajder

  3. Department of Pediatrics, Division of Adolescent Medicine, CHU Sainte-Justine, 3175 CH Côte-Sainte-Catherine, Montreal, Quebec, H3T 1C5, Canada

    Danielle Taddeo, Olivier Jamoulle, Jean-Yves Frappier & Chantal Stheneur

Authors
  1. Klara Meierer
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  2. Alexandre Hudon
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  3. Marc Sznajder
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  4. Marie-France Leduc
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Contributions

Klara Meierer M.D.:

Main author, data collection, manuscript writing, reviewer

Alexandre Hudon:

Main author, data collection, manuscript writing, reviewer

Marc Sznajder M.D.:

Data analysis, reviewer

Marie-France Leduc M.D.:

Data collection, reviewer

Danielle Taddeo M.D.:

Data collection, reviewer

Olivier Jamoulle M.D.:

Data collection, reviewer

Jean-Yves Frappier M.D.:

Data collection, reviewer

Chantal Stheneur M.D., PhD:

Supervision of data collection, supervision manuscript writing, reviewer

Corresponding author

Correspondence to Chantal Stheneur.

Ethics declarations

Ethical approval was obtained from the Sainte-Justine’s Hospital Research Ethics Board.

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Communicated by Peter de Winter

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Meierer, K., Hudon, A., Sznajder, M. et al. Anorexia nervosa in adolescents: evolution of weight history and impact of excess premorbid weight. Eur J Pediatr 178, 213–219 (2019). https://doi.org/10.1007/s00431-018-3275-y

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  • DOI: https://doi.org/10.1007/s00431-018-3275-y

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