Speaker Biography

Daniel Stein


Growth retardation is a prominent feature in adolescent anorexia nervosa (AN). Low final adult height in AN usually represents the result of severe malnutrition. Still there is limited literature about the factors affecting final adult height.

We present the findings of three studies carried out by our group assessing growth retardation in adolescents hospitalized because of AN: two retrospective studies in males (n=11) and females (n=211), and one prospective study in females (n=255). Height standard deviation scores (height-SDSs) on admission, discharge and final adult height were significantly lower than the expected height-SDS, mid-parental height-SDS, and premorbid height-SDS in both male and female adolescent AN patients. Premorbid height-SDS was within normal ranges.

Patients in all studies showed significant increase in weight during and after inpatient treatment. However, whereas the male patients showed significant acceleration in linear growth during inpatient treatment, no such improvement was found in females.

Older age and younger bone age on admission, and linear growth and increase in luteinizing hormone during hospitalization predicted improvement in height SDS in the prospective design. Last, AN patients with greater weekly weight gain (>500 grams) during inpatient treatment were higher at one-year follow-up than AN patients with less weekly weight gain (<500 grams).

The findings of these studies emphasize that growth retardation is a prominent feature in adolescents hospitalized because of AN, and that complete catch-up growth usually does not occur. The presence of compromised height already at first hospitalization suggests that delayed diagnosis and treatment in adolescent AN may increase the likelihood of compromised final adult height