Abnormal caloric requirements for weight maintenance in patients with anorexia and bulimia nervosa

Article Abstract:

Anorexia nervosa and bulimia nervosa are eating disorders that can cause severe medical problems and even death. Though treatable, the relapse rate is fairly high for reasons not well understood. Bulimia is about 10-times more prevalent than anorexia. These patients periodically binge and then purge the food from their body, but usual maintain a normal weight. Some bulimics have a history of anorexia. Anorexia is probably the best known eating disorder. Some patients lose weight by fasting or restricting food intake. Others also binge and purge. In the present study, 53 bulimic and/or anorexic women were divided into four subgroups, and daily calorie intake was recorded during a period that their weight remained stable. The four groups consisted of two subgroups of anorexics (restricting only and bulimic subtypes) and two subgroups of bulimics (with or without a history of anorexia). After treatment to restore normal weight, the caloric requirements to maintain body weight of restricting anorexics was much higher than anorexic patients who binged and purged. Previously anorexic bulimic patients required a significantly greater caloric intake to maintain their body weight than bulimics who had never been anorexic. While the differences may be methodological (i.e., in the way caloric intake and requirements were measured), these results suggest that the high rate of relapse in anorexics may be due to an elevated caloric requirement combined with reduced food intake. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Evaluation, Anorexia nervosa, Body weight

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Decrease in resting metabolic rate during abstinence from bulimic behavior

Article Abstract:

Bulimia nervosa is a disorder characterized by binge eating followed by purging to prevent weight gain. The resting metabolic rate (the energy requirement of the body in a resting state) in bulimics is usually lower than normal. The lower metabolic rate makes it easier to gain weight, which may encourage bulimic behavior. Most studies examining resting metabolic rate in bulimics that have been performed in a controlled environment only examined the metabolic rate of subjects who restrained from binging and purging behavior. This study examined resting metabolic rates of bulimics in the controlled environment of a hospital during one week of active binge eating and purging and during one week of abstinence. The resting metabolic rate was measured in eight patients actively engaging in bulimic behavior one week after admittance to a hospital. At the end of the week, the patients were restrained from such behavior for seven weeks, at which time resting metabolic rate was again measured. Resting metabolic rate significantly decreased after the bulimic behavior had been restrained, as did caloric intake and thyroid hormone levels. These results indicate that the binge eating phase of bulimic behavior may result in an increased resting metabolic rate, possibly by stimulating thyroid hormone activity. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Basal metabolism, Thyroid hormones

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