65. Longitudinal Changes in Body Composition, Anxiety, and Depression in a Clinical Sample of Adolescents with Anorexia Nervosa

Over the past several years eating disorders among children and adolescents have significantly increased. Research has shown that depression and anxiety are highly comorbid with eating disorders. However, it is unclear if anxiety and depression improve with weight restoration. Among patients with Anorexia Nervosa (AN), there is mixed literature in regards to the improvement of anxiety and depression with weight restoration and limited data in adolescents. The current longitudinal study aimed to (1) examine the change in body composition, anxiety, and depression over time and (2) examine the relationship between change in body composition and change in anxiety/depression in a population of adolescents with AN. Our sample included 63 adolescents (ages 11-20 years-old) with Anorexia Nervosa (any subtype including Atypical) from a multidisciplinary eating disorder clinic. Baseline and follow up visits were approximately 4 months apart. Parents and patients completed the PROMIS anxiety and depression short forms as part of the clinic visit. A repeated measures t-test for dependent means was used to evaluate changes between baseline and follow-up. Linear regression analyses were run to assess the relationship between change in body composition (body fat percent, visceral fat, skeletal muscle mass, and BMI percentile) and change in anxiety and depression scores. Gender was significantly related to patient-report anxiety and depression measures; therefore, gender was included in the associated linear regression models as a covariate. There were significant increases in all body composition measures (body fat percent, visceral fat, skeletal muscle mass, and BMI percentile) between visit one and two (p <.001 for all variables). Parent-reported adolescent anxiety (p = <.001) and depression (p = 0.003) scores decreased over time. Patient-reported depression (p =.035) and patient-reported anxiety (p= .035) also showed a significant decrease over time. Additional longitudinal analyses showed an increase in patient BMI percentile was significantly related to a decrease in parent-report of adolescent anxiety (β = -.281, p = 0.040) and depression (β = -.271, p = 0.050). However, none of the other body composition measures were related to change in parent-report of adolescent anxiety/depression. Additionally, no changes in any of the body composition measures were related to change in patient-reported anxiety and depression. The current study suggests that although anxiety and depression scores do improve over the course of treatment, only parent-report of improvement in their adolescent’s anxiety and depression symptoms was related to an improvement in their adolescent’s BMI percentile. Although a parent may feel their adolescent’s symptoms are remitting with weight restoration, it is possible the adolescent is not experiencing this symptom reduction to the degree parents report. These findings may support the need for separate treatment of anxiety and depression after weight restoration, as anxiety and depression cannot be expected to solely remit based upon increases in body composition alone.