TY - JOUR
T1 - Gastrointestinal symptomatology, diagnosis, and treatment history in patients with underweight avoidant/restrictive food intake disorder and anorexia nervosa
T2 - Impact on weight restoration in a meal-based behavioral treatment program
AU - Cooper, Marita
AU - Collison, Amira O.
AU - Collica, Sarah C.
AU - Pan, Isabella
AU - Tamashiro, Kellie L.
AU - Redgrave, Graham W.
AU - Schreyer, Colleen C.
AU - Guarda, Angela S.
N1 - Publisher Copyright:
© 2021 The Authors. International Journal of Eating Disorders published by Wiley Periodicals LLC.
PY - 2021/6
Y1 - 2021/6
N2 - Objective: Gastrointestinal (GI) concerns are often presumed to complicate nutritional rehabilitation for restrictive eating disorders, yet their relationship to weight restoration outcomes is unclear. This retrospective chart review examined GI history and weight-related discharge outcomes in primarily adult, underweight inpatients with anorexia nervosa (AN, N = 107) or avoidant/restrictive food intake disorder (ARFID, N = 22) treated in a meal-based, behavioral eating disorder program. Method: Lifetime GI symptomatology, diagnoses, diagnostic tests, and procedures were abstracted from medical records. Generalized linear models examined associations of GI diagnoses, tests, and procedures with discharge BMI and rate of weight gain. Results: Ninety-nine percent of patients reported GI symptomatology and 83% had one or more GI diagnoses; with constipation and GERD most common. GI diagnoses (p <.01) and testing (p <.001) were more common in ARFID than AN. Average inpatient weight gain (1.59 kg/week), and discharge BMI (18.5 kg/m2), did not differ by group. Slower weight gain in patients with (1.3 kg/week), versus without (1.7 kg/week), history of tube feeding (p =.02), accounted for a main effect of GI procedures on inpatient rate of gain (p =.01). Discussion: Despite ubiquitous GI symptomatology, meal-based weight restoration achieved average weekly weight gain above recommended APA guidelines for hospitalized patients with an eating disorder. History of tube feeding was associated with slower mean weight gain, which remained, however, within recommended APA guidelines.
AB - Objective: Gastrointestinal (GI) concerns are often presumed to complicate nutritional rehabilitation for restrictive eating disorders, yet their relationship to weight restoration outcomes is unclear. This retrospective chart review examined GI history and weight-related discharge outcomes in primarily adult, underweight inpatients with anorexia nervosa (AN, N = 107) or avoidant/restrictive food intake disorder (ARFID, N = 22) treated in a meal-based, behavioral eating disorder program. Method: Lifetime GI symptomatology, diagnoses, diagnostic tests, and procedures were abstracted from medical records. Generalized linear models examined associations of GI diagnoses, tests, and procedures with discharge BMI and rate of weight gain. Results: Ninety-nine percent of patients reported GI symptomatology and 83% had one or more GI diagnoses; with constipation and GERD most common. GI diagnoses (p <.01) and testing (p <.001) were more common in ARFID than AN. Average inpatient weight gain (1.59 kg/week), and discharge BMI (18.5 kg/m2), did not differ by group. Slower weight gain in patients with (1.3 kg/week), versus without (1.7 kg/week), history of tube feeding (p =.02), accounted for a main effect of GI procedures on inpatient rate of gain (p =.01). Discussion: Despite ubiquitous GI symptomatology, meal-based weight restoration achieved average weekly weight gain above recommended APA guidelines for hospitalized patients with an eating disorder. History of tube feeding was associated with slower mean weight gain, which remained, however, within recommended APA guidelines.
KW - anorexia nervosa
KW - avoidant restrictive food intake disorder
KW - gastrointestinal
KW - nutritional
KW - refeeding
KW - treatment
KW - tube feeding
KW - weight restoration
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U2 - 10.1002/eat.23535
DO - 10.1002/eat.23535
M3 - Article
C2 - 33973254
AN - SCOPUS:85105445657
SN - 0276-3478
VL - 54
SP - 1055
EP - 1062
JO - International Journal of Eating Disorders
JF - International Journal of Eating Disorders
IS - 6
ER -