Inpatient target discharge weight for early-onset anorexia nervosa: Restoring premorbid BMI percentile to improve height prognosis

A Ayrolles; J Clarke; M Dechaux; A Lefebvre; A Cohen; C Stordeur; H Peyre; A Bargiacchi; N Godart; H Watson; R Delorme

doi:10.1016/j.clnesp.2023.01.025

Inpatient target discharge weight for early-onset anorexia nervosa: Restoring premorbid BMI percentile to improve height prognosis

Clin Nutr ESPEN. 2023 Apr:54:150-156. doi: 10.1016/j.clnesp.2023.01.025. Epub 2023 Jan 25.

Authors

A Ayrolles¹, J Clarke², M Dechaux³, A Lefebvre⁴, A Cohen³, C Stordeur³, H Peyre⁵, A Bargiacchi³, N Godart⁶, H Watson⁷, R Delorme⁸

Affiliations

¹ Assistance Publique - Hôpitaux de Paris, Robert Debré Hospital, Child and Adolescent Psychiatry Department, Paris, France; Human Genetics & Cognitive Functions, Institut Pasteur, Paris, France. Electronic address: anael.ayrolles@aphp.fr.
² Assistance Publique - Hôpitaux de Paris, Robert Debré Hospital, Child and Adolescent Psychiatry Department, Paris, France; Centre of Psychiatry and Neuroscience, INSERM UMR 894, Paris, France.
³ Assistance Publique - Hôpitaux de Paris, Robert Debré Hospital, Child and Adolescent Psychiatry Department, Paris, France.
⁴ Assistance Publique - Hôpitaux de Paris, Robert Debré Hospital, Child and Adolescent Psychiatry Department, Paris, France; Human Genetics & Cognitive Functions, Institut Pasteur, Paris, France.
⁵ Assistance Publique - Hôpitaux de Paris, Robert Debré Hospital, Child and Adolescent Psychiatry Department, Paris, France; INSERM UMRS 1141, Paris, France; Paris University, Paris, France.
⁶ Fondation Santé des Etudiants de France, Paris, France; CESP, U1018, INSERM, Villejuif, France; UFR of Health Sciences, UVSQ, Versailles, France.
⁷ Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA; School of Psychology, Curtin University, Perth, Australia; School of Paediatrics, Division of Medicine, The University of Western Australia, Perth, Australia.
⁸ Assistance Publique - Hôpitaux de Paris, Robert Debré Hospital, Child and Adolescent Psychiatry Department, Paris, France; Human Genetics & Cognitive Functions, Institut Pasteur, Paris, France; Paris University, Paris, France.

PMID: 36963857
DOI: 10.1016/j.clnesp.2023.01.025

Abstract

Objective: Early-onset anorexia nervosa (EO-AN) is characterized by restricted food intake leading to low body weight, emerging before 14 years old. Most patients reaching a target body mass index (BMI) around the 25th percentile at hospitalization discharge display an incomplete prospective height catch-up. A better understanding of height prognosis determinants is required.

Methods: In 74 children with an EO-AN, we collected height and weight premorbidly, at hospitalization, and at discharge, 6 months, 12 months, and at longer-term follow-up of 36 months. We defined a height prognosis parameter (HPP) as the difference between the height percentile at follow-up times and the premorbid height percentile. We explored the relationship between weight parameters and height catch-up at follow-up with linear regression analyses.

Results: A higher weight suppression (WS) - i.e., difference between premorbid and current BMI - at admission and discharge was associated with lower HPP - i.e., a greater loss of height - at 12 months and 36 months follow-up. Similarly, a higher premorbid BMI percentile was associated with a lower HPP at 12 and 36 months.

Conclusion: Target discharge weight for EO-AN patients should be tailored and based on premorbid BMI trajectory to improve height prognosis.

Keywords: Anorexia nervosa; Early-onset; Height prognosis; Weight suppression.

MeSH terms

Adolescent
Anorexia Nervosa* / complications
Body Mass Index
Body Weight
Child
Humans
Inpatients
Patient Discharge
Prognosis
Prospective Studies