Behavior, attitude, nutrition and endocrinology in anorexia nervosa: A LONGITUDINAL STUDY IN 24 PATIENTS

Abstract

Anorexia nervosa patients (24) participated in an inpatient broad spectrum behavior therapy program. The changes in body weight, anorectic behaviors and attitudes and endocrine variables (24-h plasma cortisol, dexamethasone suppression test, 24-h plasma luteinizing hormone [LH]) were measured. Specific anorectic behaviors and attitudes showed significant improvement during inpatient treatment, while attitudes of a more general neurotic scope such as the feeling of insufficiency, general distress, (sexual) anxieties and anancasm did not. On admission, 24-h plasma cortisol levels were elevated, episodic secretory spikes occurred at unusual times, and the number was increased, cortisol plasma half-life was increased, and nonsuppression of cortisol secretion following the application of dexamethasone was observed. All these parameters normalized already after 10% wt gain. Twenty-four hour plasma LH pattern showed a close relationship with body weight. The dysfunctions in anorexia nervosa patients in the hypothalamo-pituitary-adrenal and -gonadal axes apparently have little specificity for this disease and are mainly a consequence of nutritional factors and starvation. The relationship between cortisol and LH-secretion, behavioral and attitudinal variables and weight gain was more complex than previously suggested by others, and a positive relationship between the LH secretory pattern and anorectic symptomatology could not be established.