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J Clin Med. 2018 Sep 18;7(9). pii: E289. doi: 10.3390/jcm7090289.

The Role of Objectively Measured, Altered Physical Activity Patterns for Body Mass Index Change during Inpatient Treatment in Female Patients with Anorexia Nervosa.

Author information

1
Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, 12200 Berlin, Germany. celine-sina.lehmann@charite.de.
2
Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany. celine-sina.lehmann@charite.de.
3
Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, 12200 Berlin, Germany. Tobias.Hofmann@charite.de.
4
Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, 12200 Berlin, Germany. Ulf.Elbelt@charite.de.
5
Center for Internal Medicine with Gastroenterology and Nephrology, Division for Endocrinology, Diabetes and Nutrition, Charité-Universitätsmedizin Berlin, 12200 Berlin, Germany. Ulf.Elbelt@charite.de.
6
Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, 12200 Berlin, Germany. Matthias.Rose@charite.de.
7
Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany. ccorrell@northwell.edu.
8
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USA. ccorrell@northwell.edu.
9
Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, NY 11004, USA. ccorrell@northwell.edu.
10
Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, 12200 Berlin, Germany. Andreas.Stengel@charite.de.
11
Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany. Andreas.Stengel@charite.de.
12
Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany. verena.haas@charite.de.

Abstract

Increased physical activity (PA) affects outcomes in patients with anorexia nervosa (AN). To objectively assess PA patterns of hospitalized AN patients in comparison with healthy, outpatient controls (HC), and to analyze the effect of PA on Body Mass Index (BMI) change in patients with AN, we measured PA in 50 female patients with AN (median age = 25 years, range = 18⁻52 years; mean BMI = 14.4 ± 2.0 kg/m²) at the initiation of inpatient treatment and in 30 female healthy controls (median age = 26 years, range = 19⁻53 years; mean BMI = 21.3 ± 1.7 kg/m²) using the SenseWear™ armband. Duration of inpatient stay and weight at discharge were abstracted from medical records. Compared with controls, AN patients spent more time in very light-intensity physical activity (VLPA) (median VLPA = 647 vs. 566 min/day, p = 0.004) and light-intensity physical activity (LPA) (median LPA = 126 vs. 84 min/day, p < 0.001) and less time in moderate-intensity physical activity (MPA) (median MPA = 82 vs. 114 min/day, p = 0.022) and vigorous physical activity (VPA) (median VPA = 0 vs. 16 min/day, p < 0.001). PA and BMI increase were not associated in a linear model, and BMI increase was mostly explained by lower admission BMI and longer inpatient stay. In a non-linear model, an influence of PA on BMI increase seemed probable (jack knife validation, r² = 0.203; p < 0.001). No direct association was observed between physical inactivity and BMI increase in AN. An altered PA pattern exists in AN patients compared to controls, yet the origin and consequences thereof deserve further investigation.

KEYWORDS:

accelerometry; eating disorders; motor restlessness; physical inactivity

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