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36
concerns about eating, weight and body shape (all highest in
HH and HL). A significant cluster x gender effect was found
for restraint eating (DEBQ) as well.
Conclusion
These re-
sults indicate that specific combinations of RS and PS seem
to enhance vulnerability for eating problems in the general
population. These
risk clusters
may differ for boys and girls.
T43
USING FMRI TO ASSESS RESPONSE TO A WEIGHT
LOSS MEDICATION
Laurel Mayer
1
, Bjorn Carlsson
2
, Yunglin Gazes
1
, Jason Stef-
fener
1
, Joy Hirsch
1
, Yaakov Stern
1
, Rudy Leibel
1
, B. Timothy
Walsh
1
1
Columbia University Medical Center, New York, NY, USA,
2
AstraZeneca, Molndal, Sweden
Purpose
To examine whether short-term sibutramine
administration is associated with changes in regional brain
activity, and if those changes are predictive of later weight
loss.
Methods
Participants were 9 obese individuals (mean
BMI 34.6±3.0 kg/m
2
). In a blinded, cross-over design, patients
were administered 1 week of 15 mg sibutramine and 2 weeks
of placebo. Testing after the end of the first and third weeks
included fMRI during which subjects viewed food and non-
food items. Following testing, patients were openly treated
with sibutramine for 6 weeks. Using SPM5, contrast testing
for the interaction between food>non-food and drug>placebo
was created for each subject and tested in a group model.
Results
Under the sibutramine>placebo condition, greater
activity was observed in 5 areas: precentral gyrus, cingulate,
inferior parietal lobule, caudate and superior frontal gyrus.
The greater the difference in brain response to food and non-
food images between drug and placebo trials, the greater the
weight loss during the 6 weeks of open sibutramine adminis-
tration. Activity in the anterior cingulate and right precentral
gyrus had the strongest association with subsequent weight
loss.
Conclusions
After only 1 week of sibutramine adminis-
tration, alterations in brain activity in response to visually pre-
sented food items can be detected. Drug-placebo differences
in region-specific activities may be predictive of subsequent
weight loss with longer-term drug administration.
T44
THIAMINE DEFICIENCY IN ANOREXIA NERVOSA
Laurie McCormick
1
, Pamela Keel
2
, Emily McCann
1
, Wayne
Bowers
1
1
University of Iowa Carver College of Medicine, Iowa City, IA,
USA,
2
Florida State University, Tallahassee, FL, USA
Introduction:
Patients with anorexia nervosa (AN) have sig-
nificant nutritional deficiencies during the starvation phase of
their illness. Cases of Wernicke’s encephalopathy in AN have
increased our interest in whether thiamine deficiency in newly
hospitalized AN patients increases risk of brain damage
following high carbohydrate meal consumption or whether
comorbid alcohol use disorders (AUD) may predict thia-
mine deficiency in AN.
Methods:
Over a 2-year period from
2009-2011, thiamine diphosphate levels were obtained as
part of routine laboratory assessments in 54 female patients
hospitalized for AN. Admission body mass indices (BMI),
AN subtype, and the presence of AUD were documented.
Results:
Seven of 54 (13%) AN patients displayed evidence
of thiamine deficiency (<70 nmol/L). Among these 7 patients,
age ranged from 20-35, average BMI was 16.6 (one outlier
had a BMI of 12.4), and 4 had the restricting type of AN. Only
2 reported using alcohol recently and met criteria for an AUD.
Six of these 7 patients were seen in follow-up, of whom 5 had
relapsed within 6 months after hospitalization.
Conclusions:
Thiamine deficiency occurs in AN in the absence of AUD or
extremely low BMI, and occurs across subtypes. While daily
oral thiamine is commonly prescribed for hospitalized AN
patients, the bioavailability of oral versus IM formulations is
only 5%. Work is needed to determine whether providing IM
thiamine for all newly admitted AN patients may protect them
from brain damage.
T45
DIAGNOSTIC SHIFTING: HOW DO PATIENTS WHO SHIFT
FROM EDNOS TO BULIMIA NERVOSA BASED ON DSM-5
CRITERIA DIFFER FROM DSM-IV BULIMIA?
Traci McFarlane
1,2,3
, Danielle E MacDonald
1,2
, Marion P Olm-
sted
1,3
1
University Health Network, Toronto, ON, Canada,
2
Ryerson
University, Toronto, ON, Canada,
3
University of Toronto,
Toronto, ON, Canada
In DSM-5, the diagnostic threshold in terms of bingeing and
compensation for bulimia nervosa (BN) will decrease from
twice to once weekly episodes for 3 months. This study
investigates the validity of this change by examining wheth-
er DSM-IV BN patients and those who will shift to BN with
DSM-5 are indeed similar on a range of variables.
Methods
:
21 EDNOS patients whose symptoms met DSM-5 criteria for
BN were compared to 131 BN patients on clinically relevant
variables. Because we were examining similarities, we used
a critical value of
p
= .2 to reduce the likelihood of Type II er-
rors.
Results
: No significant differences (
p
> .20) were found
on: BMI, drive for thinness, body dissatisfaction, interoceptive
awareness, maturity fears, body checking, weight-based
self-evaluation, perfectionism, cognitive schemas, depression
and anxiety symptoms, readiness for change, or number of
previous treatments. Differences were found on 3 subscales
of the Eating Disorder Inventory (i.e., Bulimia, Ineffectiveness
and Interpersonal Distrust), body avoidance, self-esteem,
age, and illness duration. Though the DSM-IV BN group were
older, had longer illnesses, and scored higher on Bulimia, the
“shift” group surprisingly reported more pathological scores in
all other domains with “significant” differences.
Conclusions
:
Overall, these findings support the modified criteria for BN,
suggesting that the psychopathology is comparable between
those with once weekly versus more frequent episodes.
T46
SOCIOCULTURAL RISK FACTORS FOR COMPULSIVE
EXERCISE: A PROSPECTIVE STUDY OF ADOLESCENTS
Caroline Meyer, Huw Goodwin, Emma Haycraft
Loughborough University Centre for Research into Eating
Disorders, Loughborough, United Kingdom
Objective:
The risk factors for compulsive exercise are
unknown. This study aims to explore sociocultural risk factors
for compulsive exercise using a longitudinal design.
Method:
A sample of 332 male and female adolescents (aged 13-
15 years at baseline) completed baseline measures and a
12-month follow-up assessment on sociocultural risk factors,
eating disorder psychopathology and compulsive exer-
cise.
Results:
Hierarchical regressions found that a media
pressure to be thin was a significant predictor of compulsive
exercise in girls, and this relationship was partially mediat-
ed by eating disorder psychopathology. In boys, messages
to become more muscular predicted compulsive exercise,
and this relationship was also partially mediated by eating
disorder psychopathology.
Conclusion:
Sociocultural risk
factors may play a part in the development of compulsive ex-
ercise and eating disorder psychopathology, with girls feeling
societal pressure to be thinner and boys feeling pressure to
become more muscular.
T47
Are patterns of bone loss in anorexic and
postmenopausal women similar?
gabriella milos
1
, luigi maria gallo
2
1
university hospital dep psychiatry, zurich, Switzerland,
2
uni-
versity Center of dental medicine, zurich, Switzerland
Aims
We compare bone density and bone architecture in
young women with anorexia nervosa (AN), young wom-
en, and healthy late postmenopausal women.
Methods
Three-dimensional high resolution peripheral quantitative
computed-tomography (HR-pQCT) at the ultradistal radius,
a technology providing measures of cortical and trabecular
bone density as well as microarchitecture, was performed
in 149 women: thirty-six women with AN (age 18-30 years),
thirty age-matched healthy controls as well as 83 healthy
POSTER SESSION 1 ABSTRACTS