148 - Self-reported Physical Activity in Inpatients with Anorexia Nervosa: A Cross-Sectional Analysis at Hospital Admission From the Study of Refeeding to Optimize iNpatient Gains (StRONG)
Clinical Professor Stanford University School of Medicine Palo Alto, California, United States
Background: Maladaptive exercise is well established in anorexia nervosa (AN); less is known about the association of pre-admission physical activity (PA) and illness severity among inpatients. Objective: 1) Characterize PA among patients hospitalized for malnutrition secondary to restrictive EDs. 2) Evaluate the association between PA and self-reported ED and related psychopathology, including depression, anxiety, and distress tolerance. 3) Examine the association between PA and medical acuity, including heart rate (HR), blood pressure (BP), orthostatic changes, and amenorrhea. Design/Methods: Patients enrolled in the StRONG trial at hospital admission. A subsample (91/116) with self-reported PA in the week prior (Metabolic Equivalent of Task [METs]) were assessed for AN (EDE-Q), anxiety (GAD-7), depression (PHQ-A), distress tolerance (DTS), heart rate (HR) nadir and systolic blood pressure (SBP). High vs. low PA groups were median split on daily METs. Results: Subjects were 95% female, mean(SD) age 16.6(2.5) yrs with AN (56%) or atypical AN at 84.6(11.4) %mBMI. Among 37 activities, METs were 6.8(6.6) kcal/kg/d, spent most often walking (n=72), core workout (n=52), and running (n=49). METs were greater in the high vs. low PA groups [2.3(6) v. 2.8(2), p<.001] but did not differ by diagnosis. High PA was significantly associated with worse GAD-7 [b=3.21 (CI 0.84,5.59), p=.009] and PHQ-A [b=2.91 (CI 0.14,5.7), p=.04]; a trend toward higher EDE-Q (p=0.056) and lower DTS (p=0.079), but not associated with HR, SBP, orthostatic change (p>.05).
Conclusion(s): We previously reported weight loss history related to greater medical instability in these patients; here we report that activity history relates to worse anxiety and depression, although not medical instability. Results support the value of PA assessment in inpatients with AN across the weight spectrum.
