Eating and weight disorders : EWD · 2019
Factors associated with weight gain in anorexia nervosa inpatients.
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Chatelet Solène, Wang Jen, Gjoertz Mathea, Lier Françoise, Monney Chaubert Carole, Ambresin Anne-Emmanuelle
Аннотация
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.
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.