Cross-sectional and longitudinal changes in body composition, anxiety, and depression in a clinical sample of adolescents with anorexia nervosa.

OBJECTIVE: Eating disorders among children and adolescents have increased in prevalence, and mortality rates for anorexia nervosa are among the highest for any psychiatric disorder. Our current study aimed to (a) examine the cross-sectional relationship between body composition and anxiety/depressive symptoms among 97 adolescents and young adults who have been diagnosed with anorexia nervosa, (b) examine the longitudinal changes in body composition and anxiety/depressive symptoms over three months (from baseline to follow-up visit), and (c) examine the longitudinal relationship between change in body composition and change in anxiety/depression over three months. METHOD: A retrospective chart review was conducted within an interdisciplinary eating disorder clinic between August 2019 and December 2021. In total, 97 adolescents aged 11-20 years old with diagnoses of anorexia nervosa were included in the analyses. Body composition data were collected at each visit along with parent- and youth-report measures of symptoms of anxiety/depression symptoms. RESULTS: Findings indicated adolescents demonstrated some improvement in body composition, as well as parent-reported reductions in anxiety/depression symptoms. Based on parent reports, increased BMI percentile was associated with improvements in anxiety/depression symptoms. On the other hand, youth did not report significant changes in anxiety/depressive symptoms. Additionally, there were no associated improvements with body composition measures, which may be associated with continued body dissatisfaction or symptoms of anxiety and depression predating the eating disorder. CONCLUSIONS: These results suggest the importance of including interventions addressing depression, anxiety, and body image as part of treatment.

Association between Body Composition Parameters and Heart Rate in a Sample of Adolescents with Anorexia Nervosa.

OBJECTIVES: Eating disorders affect the physical and mental health of millions of Americans. Body composition trends in relation to heart rate in adolescents with eating disorders remain understudied. The aim of the present study was to determine whether body composition parameters (percent body fat, percent skeletal muscle mass) are correlated with heart rate in a sample of adolescents with anorexia nervosa. METHODS: This study included patients 11 to 19 years old who presented to an outpatient eating disorder clinic (N = 49). Patients underwent bioelectrical impedance analysis to estimate body composition parameters. Descriptive statistics, linear regression, and paired t tests were used to evaluate the data. RESULTS: Heart rate was inversely associated with percent skeletal muscle mass (P < 0.001) and positively associated with percent body fat (P = 0.001). Patients demonstrated significant improvements in weight, body mass index percentile, skeletal muscle mass, percent body fat, and heart rate when comparing results at the first and last visits (P < 0.01). CONCLUSIONS: Overall, there was an inverse relation between percent skeletal muscle mass and heart rate and a positive association between body fat and heart rate. Our study demonstrates the importance of assessing percent body fat and skeletal muscle mass rather than weight or body mass index alone in adolescents with eating disorders.

The impact of COVID-19 on adolescents with eating disorders: Increased need for medical stabilization and decreased access to care.

OBJECTIVE: We aimed to identify trends of patients with eating disorders (EDs) requiring hospitalization before and during the pandemic at a children's hospital in the southeastern United States. METHOD: A retrospective chart review was completed for 71 adolescents and young adults (ages 10-21 years; M = 14.61, SD = 2.121). RESULTS: Results indicated a 188% increase in ED hospital admissions since the pandemic, with patients presenting with increased rates of comorbid mental health diagnoses (p = .009). During COVID-19, the development of temporary outpatient multidisciplinary discharge plans (i.e., "bridge plans") were utilized more often due to difficulties accessing the appropriate level of care (p = .039). DISCUSSION: Results suggest a significant increase in youth requiring medical stabilization for EDs since the start of the COVID-19 pandemic (2.9 times more than prepandemic), as well as a need for greater advocacy to increase specialized mental health services along the full continuum of care. PUBLIC SIGNIFICANCE STATEMENT: This study brings awareness to the significant increase in patients needing medical stabilization secondary to restrictive EDs and increased rates of comorbid mental health diagnoses in this patient population since the onset of the COVID-19 pandemic. Patients during COVID-19 were less likely to directly transition to treatment likely secondary to the strain COVID-19 placed on mental health systems/treatment centers. Increased advocacy for specialized care for eating disorder patients.