Eating Disorders (EDs) incidence is constantly increasing and spreading among female (and to a lesser extent male) adolescents from all social and cultural environments [1-4]. On the other hand, adolescence nowadays comprises a wider age range of individuals compared to the past, also due to the continuous and fast cultural and socio-economic changes. For the treatment of EDs a multi-disciplinary approach is suggested. Basically, the therapeutic team should include physicians specialized in clinical nutrition, psychiatrists, psychologists, dieticians and other supportive rehabilitative professionals. Generally, these disorders are treated on an outpatient basis; only in selected/severe cases hospital admission is required. For the treatment of the disease, patients can take advantage from the temporary leaving from the family/social environment often described to cause and sustain the dysfunctional behaviour . This kind of intervention is obtained by hosting ED patients in specialized Centers, usually for a period of time longer than 90 days. However, in the literature, at least at our knowledge, there is little description of the short and long term outcome (relapse, complications, effectiveness) of this therapeutic approach. Seventy-nine patients were admitted at the Center for the Treatment of Eating Disorders “G. Gioia” in Chiaromonte (PZ), Italy, from 2010 to 2012. Permanence in the residential Center lasted at least 3 months. Four male patients and 24 patients (age 24, 1 ± 7 years) who did not attend the follow-up (FU) visit were not included in the study. Therefore, 51 female patients, suffering from ED (AN, BN, BED, EDNOS) and attending the scheduled follow up visit, were studied. Social and demographic data as well as clinical and biochemical characteristics, anthropometry, body composition, Resting Energy Expenditure (REE) and some psychometric parameters (data not shown) at different steps of the treatment were evaluated. Before admission at the rehabilitative residential Center, patients were evaluated by a psychiatrist. The diagnosis of ED was made according to DSM-IV criteria, because the data were collected from 2010-2012, and lately confirmed according to DSM-V criteria. Patients with major psychiatric disorders, acute diseases and/or Body Mass Index (BMI=weight/squared height ) <13 Kg/m² were not admitted to the residential therapeutic program. Socio-demographic characteristics and disease history were collected at entry. Anthropometry (weight, height, BMI), clinical (Blood Pressure, Heart Rate, ECG), biochemical and body composition parameters were registered at entry and at 1–3 and 5^th month of the residential period and 6 months after discharge. Body composition was evaluated by BIA (Human II Plus DS Medica) and Resting Energy Expenditure (REE) by indirect calorimetry (VMax Sensor Medics) in standardized conditions: after an overnight fasting in a quite, thermo-neutral (22°C temperature) environment. Nutritional intervention was prescribed by the nutritionist according to patient’s energy requirements measured by indirect calorimetry and to the diet history collected at entry. Diet energy content variations during the residential period were allowed according to REE measurements. The prescribed diet was prepared following the Mediterranean Diet style and the National Guidelines for a healthy diet. At entry and at discharge, liver ultrasonography (Esaote Mpx Biomedica) was performed to evaluate the presence and grade of steatosis. Both a convex (3.5-MHz) and a linear high frequency (7-13 MHz) probes were used. The presence of liver steatosis was classified according to Saverymuttu et al.  criteria with a semi-quantitative method on a 0-3 scale: (0: normal liver; 1: slight steatosis; 2: moderate steatosis; 3: severe steatosis).

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Regards,
catherine
Journal Co-Ordinator
Joournal of Obesity and Eating Disorders