Clinical practice of body composition assessment in female subjects with anorexia nervosa

© Springer Science+Business Media, LLC 2012. All rights reserved. Anorexia Nervosa (AN) is characterised by a refusal to maintain a minimally normal body weight and by the distorted perception of one's own body (weight, size, shape) as a negative interpretation of their appearance as too fat, resulting in the intense fear of weight gain, even when severely underweight. Both from a physiological and psychological viewpoint, weight, weight restoration and body composition are crucial elements for the treatment of AN. AN patients have unrealistic ideas about body fat and the influence of food intake and dieting on body weight and shape. Over the last ten years, body composition in female anorexia nervosa has become an important topic in treatment as well as in research. Increasingly, body composition is integrated into the assessment of the evolution of AN in patients. A wide variety of methods have been used to measure body composition in anorexia nervosa. The skinfold measurements and the bio impedance analysis are most often used in clinical practices. However, clinicians have to be careful with the use of the bio impedance analysis BIA for the estimate of body fat in AN. Additionally, the body mass index (BMI) does not predict the body composition or reveal the change in body composition. There are a number of available equations to estimate the percentage of body fat from the available body density. The Siri-Formula (In: Lawrence JH, Tobias CA, editors. Advances in biological and medical physics. New York: Academic Press, p. 239-280, 1956) is recommended, with some restrictions. A weight gain program for patients with anorexia nervosa lead to a significant increase in body weight and body fat. More than half (55%) of the weight increase is attributed to the increase of fat mass. The body composition results had to be communicated and explained to the AN patients in psycho-education sessions. Here, guidelines for a standard protocol of anthropometric assessments in the clinical practice are proposed. Despite an increase in knowledge about the body composition of patients with anorexia nervosa, more fundamental research is necessary in regard to the limitations of the techniques and equations for these specific group of underweight patients.

ISBN:978-1-4419-1787-4

Jaar van publicatie:2012