{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:17:05Z","timestamp":1791303425649,"version":"4.1.0"},"reference-count":115,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,9,12]],"date-time":"2019-09-12T00:00:00Z","timestamp":1568246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007155","name":"Medical Research Council Canada","doi-asserted-by":"publisher","award":["MR\/N015746\/1"],"award-info":[{"award-number":["MR\/N015746\/1"]}],"id":[{"id":"10.13039\/501100007155","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["K01 MH109782"],"award-info":[{"award-number":["K01 MH109782"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R21 MH115397"],"award-info":[{"award-number":["R21 MH115397"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009362","name":"South London and Maudsley NHS Foundation Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009362","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["538\u20102013\u20108864"],"award-info":[{"award-number":["538\u20102013\u20108864"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["109863\/Z\/15\/Z"],"award-info":[{"award-number":["109863\/Z\/15\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2019,11]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n In accordance with PRISMA guidelines, we conducted 94 meta\u2010analyses on 62 samples published during 1996\u20132019, comparing up to 2,319 pretreatment, posttreatment, and weight\u2010recovered female patients with AN with up to 1,879 controls. Primary outcomes were fat mass, fat\u2010free mass, body fat percentage, and their regional distribution. Secondary outcomes were bone mineral density, metabolites, and hormones. Meta\u2010regressions examined relationships among those measures and moderators.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Pretreatment female patients with AN evidenced 50% lower fat mass (mean difference [MD]: \u22128.80\u2009kg, 95% CI: \u22129.81, \u22127.79,\n Q<\/jats:italic>\n = 1.01\u2009\u00d7\u200910\n \u221263<\/jats:sup>\n ) and 4.98\u2009kg (95% CI: \u22125.85, \u22124.12,\n Q<\/jats:italic>\n = 1.99\u2009\u00d7\u200910\n \u221228<\/jats:sup>\n ) lower fat\u2010free mass, with fat mass preferentially stored in the trunk region during early weight restoration (4.2%, 95% CI: \u22122.1, \u22126.2,\n Q<\/jats:italic>\n = 2.30\u2009\u00d7\u200910\n \u22124<\/jats:sup>\n ). While the majority of traits returned to levels seen in healthy controls after weight restoration, fat\u2010free mass (MD: \u22121.27\u2009kg, 95% CI: \u22121.79, \u22120.75,\n Q<\/jats:italic>\n = 5.49\u2009\u00d7\u200910\n \u22126<\/jats:sup>\n ) and bone mineral density (MD: \u22120.10\u2009kg, 95% CI: \u22120.18, \u22120.03,\n Q<\/jats:italic>\n = 0.01) remained significantly altered.\n <\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Body composition is markedly altered in AN, warranting research into these phenotypes as clinical risk or relapse predictors. Notably, the long\u2010term altered levels of fat\u2010free mass and bone mineral density suggest that these parameters should be investigated as potential AN trait markers.<\/jats:p>\n <\/jats:sec>\n \n ResumenObjetivo<\/jats:title>\n Cl\u00ednicamente, la anorexia nervosa (AN) se presenta con alteraciones en la composici\u00f3n corporal. Cuantificamos estas alteraciones y evaluamos longitudinalmente su relaci\u00f3n con metabolitos y hormonas en pacientes con AN.<\/jats:p>\n <\/jats:sec>\n \n M\u00e9todo<\/jats:title>\n De acuerdo con las pautas PRISMA, realizamos 94 meta\u2010an\u00e1lisis en 62 muestras publicadas entre 1996\u20132019, comparando hasta 2,319 pacientes mujeres en pre\u2010tratamiento, post\u2010tratamiento, 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 distribuci\u00f3n regional. Las medidas secundarias fueron densidad mineral \u00f3sea, metabolitos y hormonas. Las meta\u2010regresiones examinaron las relaciones entre esas medidas y moderadores.<\/jats:p>\n <\/jats:sec>\n \n Resultados<\/jats:title>\n \n Las pacientes femeninas con AN pre\u2010tratamiento mostraron un 50% menos de masa grasa (MD: \u22128.80\u2009kg, CI 95%: \u22129.81, \u22127.79,\n Q<\/jats:italic>\n =\u20091.01\u2009\u00d7\u200910\n \u2013<\/jats:sup>\n 63<\/jats:sup>\n ) y 4.98\u2009kg (CI 95%: \u22125.85, \u22124.12,\n Q<\/jats:italic>\n =\u20091.99\u2009\u00d7\u200910\n \u2013<\/jats:sup>\n 28<\/jats:sup>\n ) menos de masa libre de grasa, con masa grasa preferentemente almacenada en la regi\u00f3n del tronco durante la recuperaci\u00f3n temprana del peso (4.2%, CI 95%: \u22122.1, \u22126.2,\n Q<\/jats:italic>\n =\u20092.30\u2009\u00d7\u200910\n \u2013<\/jats:sup>\n 4<\/jats:sup>\n ). Aunque la mayor\u00eda de los rasgos regresaron a los niveles vistos en los controles sanos despu\u00e9s de la restauraci\u00f3n del peso, la masa libre de grasa (MD: \u22121.27\u2009kg, CI 95%: \u22121.79, \u22120.75,\n Q<\/jats:italic>\n =\u20095.49\u2009\u00d7\u200910\n \u2013<\/jats:sup>\n 6<\/jats:sup>\n ) y la densidad mineral \u00f3sea (MD: \u22120.10\u2009kg, CI 95%: \u22120.18, \u22120.03,\n Q<\/jats:italic>\n =\u20090.01) permanecieron significativamente alteradas.\n <\/jats:p>\n <\/jats:sec>\n \n Discusi\u00f3n<\/jats:title>\n La composici\u00f3n corporal es marcadamente alterada en la AN, lo que garantiza la investigaci\u00f3n en estos fenotipos como predictores de riesgo cl\u00ednico o de reca\u00edda. Notablemente, la alteraci\u00f3n a largo plazo de los niveles de masa libre de grasa y densidad mineral \u00f3sea sugieren que estos par\u00e1metros debe ser investigados como potenciales rasgos indicadores de AN.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/eat.23158","type":"journal-article","created":{"date-parts":[[2019,9,12]],"date-time":"2019-09-12T06:30:10Z","timestamp":1568269810000},"page":"1205-1223","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["Body composition in anorexia nervosa: Meta\u2010analysis and meta\u2010regression of cross\u2010sectional and longitudinal studies"],"prefix":"10.1002","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1267-8287","authenticated-orcid":false,"given":"Christopher","family":"H\u00fcbel","sequence":"first","affiliation":[{"name":"Social, Genetic & Developmental Psychiatry Centre Institute of Psychiatry, Psychology and Neuroscience, King's College London 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Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Breithaupt","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden"},{"name":"Eating Disorders Clinical and Research Program Massachusetts General Hospital Boston Massachusetts"},{"name":"Department of Psychiatry Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avina","family":"Hunjan","sequence":"additional","affiliation":[{"name":"Social, Genetic & Developmental Psychiatry Centre Institute of Psychiatry, Psychology and Neuroscience, King's College London London UK"},{"name":"UK National Institute for Health Research (NIHR) Biomedical Research Centre South London and Maudsley Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor","family":"Horne","sequence":"additional","affiliation":[{"name":"Department of Genetics, Faculty of Life Sciences and Medicine King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judit","family":"Garc\u00eda\u2010Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"School of Biological and Chemical Sciences Queen Mary, University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul F.","family":"O'Reilly","sequence":"additional","affiliation":[{"name":"Social, Genetic & Developmental Psychiatry Centre Institute of Psychiatry, Psychology and Neuroscience, King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia M.","family":"Bulik","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden"},{"name":"Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina"},{"name":"Department of Nutrition University of 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