Impact of Antipsychotic Medications on Weight Gain and Eating
                    Disorder-Related Psychopathology in Adult Inpatients with Anorexia
                    Nervosa

Tabea Bauman; David R. Kolar; Christoph U. Correll; Verena Haas; Ulrich Voderholzer

doi:10.1055/a-2436-9552

Pharmacopsychiatry, Table of Contents

Pharmacopsychiatry 2025; 58(02): 80-87
DOI: 10.1055/a-2436-9552

Original Paper

Impact of Antipsychotic Medications on Weight Gain and Eating Disorder-Related Psychopathology in Adult Inpatients with Anorexia Nervosa

Tabea Bauman

¹Schoen Clinic Roseneck, Prien am Chiemsee, Germany

,

David R. Kolar

²Clinical Child and Adolescent Psychology and Psychotherapy, Department of Psychology, University of Regensburg, Regensburg, Germany

³Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany

,

Christoph U. Correll

⁴Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany

⁵Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA

⁶Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, New York, USA

⁷Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York, USA

,

Verena Haas

⁴Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany

,

Ulrich Voderholzer

¹Schoen Clinic Roseneck, Prien am Chiemsee, Germany

³Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany

⁸Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, Freiburg, Germany

› Author Affiliations

Abstract

Introduction The impact of antipsychotic use on weight gain and eating disorder-related psychopathology in adult inpatients with anorexia nervosa (AN) is unclear.

Methods Consecutively hospitalized adults with AN were retrospectively analyzed. Co-primary outcomes were body mass index (BMI) and weekly weight change. Secondary outcomes were Eating Disorder Inventory-2 (EDI-2) subscale scores ‘drive for thinness’ and ‘body dissatisfaction’. Admission-to-discharge changes were compared in patients continuing pre-admission antipsychotics (APcont), starting antipsychotics (APnew) and patients without psychopharmacotherapy (noMed) using linear mixed models. Sensitivity analyses were conducted in subgroups matched for age, length of stay, baseline BMI and baseline EDI-2 scores. Subgroups were also compared regarding BMI trajectories, using non-linear growth curve models. Within-group analyses compared weight gain before vs. after the median antipsychotic onset week.

Results Of 775 adult inpatients (mean length of stay =103.5±48.0 days), 21.7% received antipsychotics (APcont =7.7%; APnew=13.9%), i. e., olanzapine (n=127, dose =5.5±3.1 mg/day) or quetiapine (n=41, dose=100.0±97.7 mg/day), while 78.3% did not receive any medication. Comparing all three groups, a significant time×group interaction was found for noMed and APnew vs. APcont (p=0.011), but this effect disappeared when comparing matched subgroups. However, in matched subgroups (n=54 each) APnew showed steeper weight gain vs. APcont both overall (p=0.011) and after median antipsychotic initiation (5.8±5.0 weeks) (p≤0.001). No significant group differences emerged in EDI-2 subscale scores.

Discussion In this naturalistic study, 22% of adult inpatients received antipsychotics. However, neither weight gain nor AN-related psychopathology changed differently in patients treated with vs. without antipsychotics. Newly initiated antipsychotic treatment vs. continuation from pre-admission had better weight gain outcomes.

Keywords

anorexia nervosa - adults - inpatients - weight gain - antipsychotics

Full Text

References

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