One Negative Effect of Weight Restoration among Men

Vol. 28 / No. 4 — Eating Disorders Review

In one study, short-term weight gains led to abnormal adipose tissue deposits in the abdomen.

Men recovering from anorexia nervosa (AN) may regain weight in an unhealthy way, according to a team of Italian researchers. In the first study to assess body composition in men with AN and how this changes with final weight restoration, Marwan El Ghoch, MD, and colleagues at Villa Garda Hospital, Verona, Italy, found that short-term weight restoration resulted in a pattern of abnormal central adiposity (Int J Eat Disord. 2017; doi:10.1022/eat.22721).

The researchers used dual-energy x-ray absorptiometry (DXA) to measure body composition in 10 men before and after complete weight restoration and in a control group of 10 healthy men matched by age and the AN patients’ post-treatment body mass index (BMI, kg/m2).

Treatment involved an adapted intensive form of enhanced cognitive behavioral therapy (CBT-E) for 13 weeks, followed by 7 weeks of CBT-E treatment given in a day hospital. During the early weeks of the program, patients work with a dietician until their BMI reaches 18.5. The program incrementally increases daily energy intake from 1500 to 3000 kcal. Once the patient’s BMI reaches 19.0, dietary intake is adjusted so hus body weight remains stable within a 2-kg window. Men whose medical conditions remained stable also had twice-weekly physical exercise sessions led by a physiotherapist. During these sessions, patients performed calisthenics to restore muscle strength and flexibility and to improve posture; aerobic exercises were used to help improve cardiovascular health.

Three patterns emerged with weight gain

The researchers reported three notable changes as the patients regained their body weight. First, the men appeared to have lost proportionately larger amounts of adipose tissue in their arms and legs than in their trunks. Second, as expected, the men with AN had lower BMIs, total lean mass scores, and fat mass scores before treatment than did their healthy peers (not surprisingly).

Finally, after short-term weight restoration, the men with AN had gained more body fat in their midsection in contrast to the healthy age-matched men. Dr. El Ghoch noted that his group had reported the same pattern of change in body composition with weight restoration in an earlier study of women with AN.