Menstrual cycle loss and resumption among patients with anorexia nervosa spectrum eating disorders: Is relative or absolute weight more influential?

Int J Eat Disord. 2017 Apr;50(4):442-446. doi: 10.1002/eat.22697. Epub 2017 Mar 6.


Objective: Prior research suggests that both body mass index (BMI) and weight suppression (highest past weight minus current weight; WS) are important in determining adult anorexia nervosa (AN) severity. We examined associations between amenorrhea and WS, DSM-5 BMI severity category, and highest premorbid BMI among patients with AN.

Method: Participants (N = 69) were adult female AN-spectrum patients at two residential treatment facilities. At admission, height, and weight were measured, and participants completed questionnaires assessing menstrual status and weight history.

Results: Greater WS, adjusted for BMI, was associated with menstrual function at admission. First amenorrhea onset occurred at a normal BMI for 38.5% of participants. Premorbid highest BMI positively correlated with BMI at amenorrhea onset, and higher BMI at amenorrhea onset was associated with higher BMI at menses resumption.

Discussion: These findings add to the literature indicating that relative and absolute weight status are dual indicators of illness severity in AN, and preliminarily suggest that a large proportion of adults who present for treatment initially may have shown symptoms of starvation at a normal BMI. Results underscore the need to focus on weight loss in early detection efforts and may inform target weight setting in the treatment of AN.

Keywords: amenorrhea; anorexia nervosa; menstrual status; weight history; weight suppression.

MeSH terms

  • Adolescent
  • Adult
  • Amenorrhea / etiology
  • Amenorrhea / physiopathology*
  • Anorexia Nervosa / complications
  • Anorexia Nervosa / physiopathology*
  • Anorexia Nervosa / therapy*
  • Body Mass Index*
  • Body Weight / physiology*
  • Female
  • Humans
  • Menstrual Cycle / physiology*
  • Young Adult