Regional fat distribution in adolescents with anorexia nervosa:: effect of duration of malnutrition and weight recovery

Objective: This study addresses the influence of the duration of malnutrition and the effect of weight recovery on regional fat mass distribution in moderately malnourished adolescents with anorexia nervosa (AN). Study design: We measured total and regional fat mass and leptin levels in 42 restrictive AN female adolescents and 23 controls. AN patients, followed over 2 years, were divided into three groups: prolonged moderate malnutrition (PM; secondary amenorrhea for over I year, n = 14); SM, short period of moderate malnutrition (secondary amenorrhea for less than I year, n = 13); and R, recovered from AN (BMI, body mass index and menses recovered for over 6 months, n = 15). Results: Total, trunk, and extremity fat mass were reduced in the PM and SM groups (P < 0.05), whereas only PM patients showed altered regional fat distribution witha low trunk to extremity fat ratio (P < 0.05). BMI increased after 1.2 months only in the SM group (P < 0.05), with menses resumption in 69%) of these patients and BMI normalization at 24 months. Their regional fat distribution was similar to controls throughout the study. No difference in any parameter was found between the R group and the controls. Conclusion: Prolonged malnutrition, but not weight recovery, is associated with an abnormal regional fat distribution pattern in moderately malnourished AN adolescents.