Body composition in anorexia nervosa: Meta‐analysis and meta‐regression of cross‐sectional and longitudinal studies
Bibliographic record
Abstract
Abstract Objective Clinically, anorexia nervosa (AN) presents with altered body composition. We quantified these alterations and evaluated their relationships with metabolites and hormones in patients with AN longitudinally. Method In accordance with PRISMA guidelines, we conducted 94 meta‐analyses on 62 samples published during 1996–2019, comparing up to 2,319 pretreatment, posttreatment, and weight‐recovered female patients with AN with up to 1,879 controls. Primary outcomes were fat mass, fat‐free mass, body fat percentage, and their regional distribution. Secondary outcomes were bone mineral density, metabolites, and hormones. Meta‐regressions examined relationships among those measures and moderators. Results Pretreatment female patients with AN evidenced 50% lower fat mass (mean difference [MD]: −8.80 kg, 95% CI: −9.81, −7.79, Q = 1.01 × 10 −63 ) and 4.98 kg (95% CI: −5.85, −4.12, Q = 1.99 × 10 −28 ) lower fat‐free mass, with fat mass preferentially stored in the trunk region during early weight restoration (4.2%, 95% CI: −2.1, −6.2, Q = 2.30 × 10 −4 ). While the majority of traits returned to levels seen in healthy controls after weight restoration, fat‐free mass (MD: −1.27 kg, 95% CI: −1.79, −0.75, Q = 5.49 × 10 −6 ) and bone mineral density (MD: −0.10 kg, 95% CI: −0.18, −0.03, Q = 0.01) remained significantly altered. Discussion Body composition is markedly altered in AN, warranting research into these phenotypes as clinical risk or relapse predictors. Notably, the long‐term altered levels of fat‐free mass and bone mineral density suggest that these parameters should be investigated as potential AN trait markers. ResumenObjetivo Clínicamente, la anorexia nervosa (AN) se presenta con alteraciones en la composición corporal. Cuantificamos estas alteraciones y evaluamos longitudinalmente su relación con metabolitos y hormonas en pacientes con AN. Método De acuerdo con las pautas PRISMA, realizamos 94 meta‐análisis en 62 muestras publicadas entre 1996–2019, comparando hasta 2,319 pacientes mujeres en pre‐tratamiento, post‐tratamiento, y recuperadas en base al peso con hasta 1,879 controles. Las principales medidas fueron masa grasa, masa libre de grasa, porcentaje de grasa corporal y su distribución regional. Las medidas secundarias fueron densidad mineral ósea, metabolitos y hormonas. Las meta‐regresiones examinaron las relaciones entre esas medidas y moderadores. Resultados Las pacientes femeninas con AN pre‐tratamiento mostraron un 50% menos de masa grasa (MD: −8.80 kg, CI 95%: −9.81, −7.79, Q = 1.01 × 10 – 63 ) y 4.98 kg (CI 95%: −5.85, −4.12, Q = 1.99 × 10 – 28 ) menos de masa libre de grasa, con masa grasa preferentemente almacenada en la región del tronco durante la recuperación temprana del peso (4.2%, CI 95%: −2.1, −6.2, Q = 2.30 × 10 – 4 ). Aunque la mayoría de los rasgos regresaron a los niveles vistos en los controles sanos después de la restauración del peso, la masa libre de grasa (MD: −1.27 kg, CI 95%: −1.79, −0.75, Q = 5.49 × 10 – 6 ) y la densidad mineral ósea (MD: −0.10 kg, CI 95%: −0.18, −0.03, Q = 0.01) permanecieron significativamente alteradas. Discusión La composición corporal es marcadamente alterada en la AN, lo que garantiza la investigación en estos fenotipos como predictores de riesgo clínico o de recaída. Notablemente, la alteración a largo plazo de los niveles de masa libre de grasa y densidad mineral ósea sugieren que estos parámetros debe ser investigados como potenciales rasgos indicadores de AN.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".