Research Article| Volume 22, ISSUE 10, P1253-1263, October 1987

Relationship of clinical factors to caloric requirements in subtypes of eating disorders

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      Caloric requirements for weight gain in subgroups of anorectic patients (anorectic restrictors, anorectic binge-purgers) and weight maintenance in subgroups of anorectic and bulimic patients (bulimics with and without a prior history of anorexia nervosa) were studied in a total of 36 patients. No significant differences were found between subgroups of anorectic patients either in calories to gain weight or to maintain a normal weight. Bulimic patients, as a group, were found to require significantly more calories than the group of anorectic patients to maintain a normal weight. Bulimic patients with a prior history of anorexia nervosa were found to require more calories for weight maintenance than bulimics with no such prior history. In the entire eating disorder population, there was a significant negative correlation between highest premorbid body mass index (BMI) and calories required to maintain weight. These findings suggest that differences in energy metabolism may be present in the eating disorder subgroups.
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        • Abraham S
        Weights by height and age for adults 18–24 years, United States 1971-74. Data from NHANES: No. 208.
        in: DHEW Publication No. (PHS) 79-1656. Government Printing Office, Washington, DC1979
        • Abraham S
        • Beaumont PJV
        • Cobbin DM
        Catecholamine metabolism and body weight in anorexia nervosa.
        Br J Psychiatry. 1981; 138: 244-247
        • Beaumont PJV
        • George GCW
        • Smart DE
        Dieters and vomiters and purgers in anorexia nervosa.
        Psychol Med. 1976; 6: 617-622
        • Beck AT
        • Ward CH
        • Mendelson M
        • Mock JE
        • Erbaugh JK
        An inventory for measuring depression.
        Arch Gen Psychiatry. 1961; 4: 561-577
        • Casper RG
        • Eckert ED
        • Halmi KA
        • Goldberg SC
        • Davis JM
        Bulimia: Its clinical importance in patients with anorexia nervosa.
        Arch Gen Psychiatry. 1980; 37: 1030-1035
        • Committee on Dietetics of the Mayo Clinics
        Mayo Clinic Diet Manual.
        in: WB Saunders, Philadelphia1971
        • Dempsey DT
        • Crosby LO
        • Pertschuk M
        • Feure ID
        • Buzby GP
        • Mullen JL
        Weight gain and nutritional efficacy in anorexia nervosa.
        Am J Clin Nutr. 1984; 39: 236-242
        • Forbes GB
        • Kreipe RE
        • Lipinski B
        Body composition and the energy cost of weight gain.
        Human Nutr Clin Nutr. 1982; 36: 485-487
        • Frisch RE
        • MacArthur JW
        Menstrual cycles: Fatness as a detriment of minimum weight for height necessary for their maintenance or onset.
        Science. 1974; 185: 949-951
        • Garner DM
        • Garfinkel PE
        • O'Shaughnessy M
        The validity of the distinction between bulimia with and without anorexia nervosa.
        Am J Psychiatry. 1985; 142: 581-587
        • Garrow JS
        Energy Balance and Obesity in Man.
        Elsevier-North Holland, Amsterdam1978
        • Garrow JS
        • Webster J
        Quetelets Index (w/H2) as a measure of fatness.
        Int J Obes. 1985; 9: 147-153
        • Gross HA
        • Lake RC
        • Ebert MH
        • Ziegler MG
        • Kopin IS
        Catecholamine metabolism in primary anorexia nervosa.
        J Clin Endocrinol Metab. 1979; 49: 805-809
        • Halmi KA
        • Dekirmenjian H
        • Davis JM
        • Casper RC
        • Goldberg S
        Catecholamine metabolism in anorexia nervosa.
        Arch Gen Psychiatry. 1978; 35: 458-460
        • Hamilton M
        A rating scale for depression.
        J Neurol Neurosurg Psychiatry. 1960; 23: 56-61
        • Kaye WH
        • Ebert MH
        • Raleigh M
        • Lake RC
        Abnormalities in CNS monoamine metabolism in anorexia nervosa.
        Arch Gen Psychiatry. 1984; 41: 350-355
        • Kaye WH
        • Jimerson DC
        • Lake R
        • Ebert MH
        Altered norepinephrine metabolism following long term weight recovery in patients with anorexia nervosa.
        Psychiatry Res. 1985; 14: 333-342
        • Kaye WH
        • Gwirtsman H
        • George T
        • Ebert M
        • Peterson R
        Caloric consumption and activity levels in anorexia nervosa: A prolonged delay in normalization.
        Int J Eat Disord. 1986; 5: 489-502
        • Kaye WH
        • Gwirtsman HE
        • Obarzanek E
        • George T
        • Jimerson DC
        • Ebert MH
        Caloric intake necessary for weight maintenance in anorexia nervosa: Non-bulimics require greater caloric intake than bulimics.
        Am J Clin Nutr. 1986; 44: 435-443
        • Lacey JH
        Bulimia nervosa, binge eating and psychogenic vomiting: A controlled treatment study and long term outcome.
        Br Med J. 1983; 286: 1609-1613
        • Landsberg L
        • Young J
        Fasting, feeding and regulation of sympathetic nervous system.
        N Engl J Med. 1978; 298: 1295-1301
        • Leibel RL
        • Hirsch J
        Diminished energy requirements in reduced-obese patients.
        Metabolism. 1984; 33: 164-170
        • McArdle W
        • Katch F
        • Katch V
        Exercise Physiology: Energy Nutrition and Human Performance.
        Lea & Febiger, Philadelphia1981
        • Pennington JA
        • Church HN
        Food Values of Portions Commonly Used.
        Harper and Row, New York1980
        • Russell GFM
        • Mezey AG
        An analysis of weight gain in patients with anorexia nervosa treated with high caloric diets.
        Clin Sci. 1962; 23: 449-460
        • Stordy BJ
        • Marks V
        • Kalucy RS
        • Crisp AH
        Weight gain, thermic effect of glucose and resting metabolic rate during recovery from anorexia nervosa.
        Am J Clin Nutr. 1977; 30: 138-146
        • Walker J
        • Roberts SI
        • Halmi KA
        • Goldberg SC
        Caloric requirements for weight gain in anorexia nervosa.
        Am J Clin Nutr. 1979; 32: 1396-1400