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J Adolesc Health. 2017 Jun;60(6):674-679. doi: 10.1016/j.jadohealth.2017.01.001. Epub 2017 Mar 8.

History of Overweight/Obesity as Predictor of Care Received at 1-year Follow-Up in Adolescents With Anorexia Nervosa or Atypical Anorexia Nervosa.

Author information

1
Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Psychology, Florida State University, Tallahassee, Florida. Electronic address: kennedy@psy.fsu.edu.
2
Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.
3
Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.
4
Division of Adolescent Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan; Formerly at the Division of Adolescent Pediatrics, Beaumont Children's Hospital, Royal Oak, Michigan.
5
Division of Adolescent Medicine, Steven and Alexandra Cohen Children's Medical Center, North Shore-Long island Jewish Health System, New Hyde Park, New York; Department of Pediatrics, Hofstra Northwell School of Medicine, Hempstead, New York.
6
Division of Adolescent Medicine and Eating Disorders, Penn State Children's Hospital, Hershey, Pennsylvania.
7
Division of Adolescent and Young Adult Health, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
8
Division of Adolescent Medicine, Stanford University School of Medicine, Stanford, California.
9
Division of Adolescent Medicine, University of California San Francisco, San Francisco, California.
10
Center for Adolescent Medicine, Department of General Pediatrics, Cleveland Clinic Children's Hospital, Cleveland, Ohio.

Abstract

PURPOSE:

Previous research has indicated that patients with anorexia nervosa (AN) or atypical AN with premorbid history of overweight/obesity have greater weight loss and longer illness duration than patients with no such history. However, little is known about the association of premorbid overweight/obesity and receiving inpatient medical care during treatment for an eating disorder.

METHODS:

Using logistic regression, we sought to determine if history of overweight/obesity was associated with receiving inpatient medical care in a sample of 522 patients (mean age 15.5 years, 88% female) with AN/atypical AN.

RESULTS:

Binary results demonstrated greater percent weight loss (27.4% vs. 16.2%) and higher percent median body mass index (%mBMI, 99.8% vs. 85.2%) at presentation in those with a history of overweight/obesity (p < .001) but no difference in duration of illness (p = .09). In models adjusted for demographics and percent weight loss, history of overweight/obesity was associated with lower odds of receiving inpatient medical care (odds ratio .60 [95% confidence interval: .45-.80]) at 1-year follow-up. However, these associations were no longer significant after adjusting for %mBMI. Mediation results suggest that %mBMI fully mediates the relationship between history of overweight/obesity and inpatient medical care, in that those with a history of overweight/obesity are less likely to receive care due to presenting at a higher weight.

CONCLUSIONS:

Our findings suggest that, despite greater degree of weight loss and no difference in duration of illness, participants with a history of overweight/obesity are less likely to receive inpatient medical care.

KEYWORDS:

Adolescents; Anorexia nervosa; Atypical anorexia nervosa; Eating disorder; Inpatient medical care; Obesity; Overweight; Percent median body mass index; Percent weight loss

[Indexed for MEDLINE]

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