Premorbid obesity and weight gain velocity: Recovery related outcomes for adolescents with Anorexia Nervosa 1 year post inpatient admission

This retrospective longitudinal study evaluated differences in weight related outcomes post-discharge from an inpatient eating disorder unit among 214 adolescents with Anorexia Nervosa (AN) and Atypical AN with and without premorbid overweight/obesity. Participants who had premorbid overweight/obesity were more likely to be male, Latino, have longer hospitalizations, and have a diagnosis of AN - Binge Purge type. Participants with premorbid overweight/obesity appeared to have lower relative weight velocity at the 3-, 6-, and 12-month follow-up assessments compared with participants without premorbid overweight. However, linear mixed-effects models did not identify significant differences in longitudinal %mBMI or %TGW trajectories between groups. While there were no significant differences in meeting the 95th % or greater TGW at 3, 6 or 12 month post discharge follow up between groups, participants with premorbid overweight/obesity were less likely to be at or above the 99th % TGW at all follow-ups (3, 6, and 12 mos). A chart review of 48 adolescents with premorbid overweight/obesity who did not meet ≥99% TGW within 1 year of discharge found that 19 (40%) met the a priori criteria for recovery despite not reaching TGW. In a sensitivity analysis applying the same three non-menstrual criteria to males and females, 20 (42%) met all criteria, suggesting that the overall finding was not substantially influenced by the sex-specific menstrual criterion. Ongoing research is needed to better understand recovery among adolescents with AN/AAN and premorbid overweight/obesity to determine how individualized, multidomain markers of recovery may complement weight-based treatment targets.