Status: Funded - Open
Trevor Griffen, MD, PhD
BACKGROUND: Atypical anorexia nervosa is a recently recognized eating disorder characterized by the same features as anorexia nervosa except that despite significant weight loss, individuals with atypical anorexia nervosa weigh within or above the “normal” range. Emerging data have documented that atypical anorexia nervosa is associated with substantial morbidity. GAP: Decades of experience with anorexia nervosa have led to the consensus that a critical first step in treatment is the restoration of body weight to the “normal” range which leads to normalization of metabolic and endocrine function. While it is generally believed that some degree of weight restoration is appropriate in the treatment of atypical anorexia nervosa, precisely how much weight gain is ideal is not known. HYPOTHESIS: 1) Adolescents with atypical anorexia nervosa have suppressed metabolic function, dysfunction of the hypothalamic-pituitary-gonadal/adrenal axes and suppressed appetitive hormones. 2) Normalization of these functions and optimization of health outcomes will not require that weight be restored to the premorbid level. METHODS: Adolescent females with atypical anorexia nervosa (n=10) and healthy controls (n=10) will be recruited and we will measure thyroid, gonadal, adrenal and appetitive hormones, resting energy expenditure and body composition at baseline, monthly until reaching clinician determined “target weight,” and at 6 months. We will test their association with psychological health, bone mineral density, all cause hospitalization and weight loss from “target weight.” RESULTS: Pending. IMPACT: No evidence-based guidelines regarding weight restoration for adolescents with atypical anorexia nervosa exist. This project will lay a foundation for the development of a biologically informed, personalized treatment goal.