Relationship between body mass index during diagnosis and medical complications in patients with eating disorders

Eating disorders (ED), mainly anorexia nervosa (AN) and bulimia nervosa (BN), are psychiatric disorders that typically start in adolescence and are accompanied by complications that concern all body systems. In this thesis, it was aimed to retrospectively evaluate the relationship between medical complications and VA-related values (body mass index (BMI), BMI percentile and ideal body weight (IBW) percentage) in patients with ED. Patients who were evaluated at least once in the Adolescent outpatient clinic of Ankara Bilkent City Hospital Pediatric Department and were diagnosed with eating disorders (AN, BN, ARFID) according to DSM-V diagnostic criteria were included in this study. The study included 144 adolescents. BMI, BMI percentile, and percentages of IBW of the patients were calculated at the time of diagnosis. The relationship between complications and BMI <18 kg/m2 and ≥18 kg/m2, BMI percentile <5 and ≥5, and percentage of IBW <75% and ≥75% was evaluated according to ED types. In our study, 140 (97,2%) of the patients were female and 4 (2,8%) were male. 128 (88,8%) of the patients had AN, of which 86 (67,1%) had restrictive type AN, 14 (10,9%) had purging type AN, and 28 (21,8%) had atypical AN. Seventeen (11,8%) of our patients were diagnosed with BN and 5 (3,5%) with ARFID. 66 (45,8%) of the patients were hospitalized. The most common complications in hospitalized patients were bradycardia in 22 (%51,1) and hypoglycemia in 16 (%37,2). Of the total 48 patients with secondary amenorrhea, 40 had restrictive type AN, two had purging type AN, four had atypical AN, and two had BN. Three out of four patients with primary amenorrhea had restrictive type AN. The presence of any cardiac complication was statistically significantly higher in patients with IBW<75% (p<0.001). Pericardial effusion was significantly more common in those with bradycardia (p=0.007). Amenorrhea, hypoglycemia, and low T3 were found to be statistically significantly higher in patients with a percentage of IBW <75% and BMI <18 kg/m2 (p<0.05). A significant, negative, and moderate relationship was found between BMD Z-score values and duration of amenorrhea (p<0.05). In conclusion, patients with ED often have at least one medical complication. As patients with low BW often have more frequent and severe medical complications, AN should be considered while excluding organic causes in primarily female patients presenting with any symptom of low BW. Anahtar Kelimeler: Adolescent; Medical Complication; Body Mass İndex; Anorexia Nervosa; Blumia Nervosa