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Factors associated with weight gain in anorexia nervosa inpatients

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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Objective

Nutrition restoration in inpatients with anorexia nervosa (AN) is a core element in treatment, enabling recovery of cognitive functions essential for psychological care. This study aims to identify factors associated with inpatient weight gain.

Methods

Medical records from 107 inpatients aged 13–55 years with AN, hospitalized for more than 7 days at a specialized unit, were examined in a retrospective study. Weight evolution graphs were created for each patient and graded independently as optimal, moderate, and inadequate weight gain after 2 weeks and increasing, flat or decreasing weight in the first 2 weeks by expert clinicians. Driven by explicit hypotheses, bivariable analyses were carried out to detect relevant factors associated with weight gain during and after the first 2 weeks of admission.

Results

Initial weight gain in the first 2 weeks of hospitalization and the introduction of a protocol harmonizing treatment procedures around rapid refeeding were strong factors associated with optimal weight gain after 2 weeks of hospitalization, whereas prior hospitalization in a psychiatric unit, diagnosis with binge-eating/purging subtype and age over 18 years were significantly associated with inadequate weight gain (p < 0.001–0.05).

Conclusion

To promote weight gain during hospitalization, clinicians should consider the following therapeutic measures: rapid refeeding strategies, renutrition protocols, and controlling purging behaviors.

Level of evidence

Level III, retrospective cohort study.

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Acknowledgements

The authors would like to thank Dr. Andreas Niedegger and Dr. Pauline Coti Bertrand for their expertise and support.

Funding

This research did not receive any specific Grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland

    Solène Chatelet, Mathea Gjoertz & Anne-Emmanuelle Ambresin

  2. Interdisciplinary Division for Adolescent Health (DISA), Lausanne University Hospital (CHUV), Hôpital Nestlé 04-312, Avenue de la Sallaz 2, 1011, Lausanne, Switzerland

    Jen Wang, Françoise Lier & Anne-Emmanuelle Ambresin

  3. Etablissements Hospitaliers du Nord-Vaudois (eHnv): St. Loup Hospital, Pompaples, Switzerland

    Carole Monney Chaubert

  4. Vaudois Centre for Anorexia and Bulimia (abC), Lausanne University Hospital (CHUV), Lausanne, Switzerland

    Françoise Lier

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  1. Solène Chatelet
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Correspondence to Anne-Emmanuelle Ambresin.

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Ethical approval

The study for this publication was approved by the Vaud Cantonal Ethics Committee.

Informed consent

The Vaud Cantonal Ethics Committee approved this retrospective medical records study without requiring patient informed consent.

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Chatelet, S., Wang, J., Gjoertz, M. et al. Factors associated with weight gain in anorexia nervosa inpatients. Eat Weight Disord 25, 939–950 (2020). https://doi.org/10.1007/s40519-019-00709-5

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  • DOI: https://doi.org/10.1007/s40519-019-00709-5

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