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The longitudinal BMI pattern and body composition of patients with anorexia nervosa who require urgent hospitalization: A case control study

Keisuke Kawai1*, Sakino Yamashita1, Takeharu Yamanaka2, Motoharu Gondo1, Chihiro Morita1, Takehiro Nozaki1, Shu Takakura1, Tomokazu Hata1, Yu Yamada1, Sunao Matsubayashi3, Masato Takii1, Chiharu Kubo1 and Nobuyuki Sudo1

Author Affiliations

1 Department of Psychosomatic Medicine, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan. 3-1-1 Higashi-ku, Fukuoka, Japan 812-8582

2 Institute for Clinical Research, National Kyushu Cancer Center, Fukuoka, Japan

3 Fukuoka Tokushukai Medical Center, Fukuoka, Japan

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BioPsychoSocial Medicine 2011, 5:14  doi:10.1186/1751-0759-5-14

Published: 5 December 2011

Abstract

Background

The prevention of serious physical complications in anorexia nervosa (AN) patients is important. The purpose of this study is to clarify which physical and social factors are related to the necessity for urgent hospitalization of anorexia nervosa (AN) patients in a long-term starvation state. We hypothesized that the change of longitudinal BMI, body composition and social background would be useful as an index of the necessity for urgent hospitalization.

Methods

AN patients were classified into; urgent hospitalization, due to disturbance of consciousness or difficulty walking(n = 17); planned admission (n = 96); and outpatient treatment only groups (n = 136). The longitudinal BMI pattern and the clinical features of these groups were examined. In the hospitalization groups, comparison was done of body composition variation and the social background, including the educational level and advice from family members.

Results

After adjusting for age and duration of illness, the BMI of the urgent hospitalization group was lower than that of the other groups at one year before hospitalization (P < 0.01) and decreased more rapidly (P < 0.01). Urgent hospitalization was associated with the fat free mass (FFM) (P < 0.01). Between the groups, no considerable difference in social factors was found.

Conclusions

The longitudinal pattern of BMI and FFM may be useful for understanding the severity in AN from the viewpoint of failure of the homeostasis system.