STUDY OBJECTIVE Adolescents with eating disorders and a history of overweight present with higher weights, longer duration of disease, but equally severe symptomatology compared with previously normal weight patients. To better delineate treatment goals for this understudied population, we compared weight at menses resumption with premorbid maximum weight among previously overweight and normal weight patients. DESIGN Retrospective cohort study. SETTING Outpatient adolescent medicine clinic at an eating disorder referral center. PARTICIPANTS Postmenarchal patients meeting criteria for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition eating disorders. History of overweight was defined as a body mass index (BMI) greater than or equal to the 85th percentile or 25 or more. INTERVENTIONS AND MAIN OUTCOME MEASURES Weight characteristics at presentation and menses resumption (BMI, BMI z-score, change from maximum weight to presentation weight) RESULTS: Previously overweight patients presented with greater mean weight, longer duration of disease, and higher BMI than previously normal weight patients. No difference was found in rates of amenorrhea at presentation or menses resumption. Previously overweight patients resumed menses at a younger age and higher BMI z-scores. The difference between weight at menses resumption and premorbid maximum weight was greater for previously overweight patients. CONCLUSION Previously overweight patients with eating disorders present differently than their normal-weight peers, so reliance on weight status as a screening criterion might result in underdiagnosis. Although BMI z-scores associated with menses resumption are higher for previously overweight patients, there is no difference in weight gain between presentation and menses resumption and time to menses resumption compared with previously normal-weight patients. Moreover, menses resumption occurred at weights significantly lower than premorbid maximum weight for previously overweight patients, so restoration to highest premorbid weight is not necessary.

中文翻译：

---

先前饮食失调的超重患者的月经回归。

研究目的与饮食正常和体重正常的青少年相比，饮食失调和有超重病史的青少年体重更高，病程更长，但症状也同样严重。为了更好地描述该人群的治疗目标，我们比较了先前超重和正常体重患者经月经恢复时的体重与病前最大体重的差异。设计回顾性队列研究。在饮食失调转诊中心设置门诊青少年医学诊所。参与者月经后患者符合《精神障碍诊断和统计手册》第五版饮食失调的标准。超重史定义为体重指数（BMI）大于或等于第85个百分位数或25或更高。干预措施和主要观察指标表现和月经恢复时体重特征（BMI，BMI z评分，从最大体重改变为表现体重）结果：以前超重的患者平均体重较重，病程更长，BMI较先前正常体重患者。出现闭经或月经恢复时闭经率无差异。以前，超重患者在更年轻，BMI z得分更高的情况下恢复月经。对于以前超重的患者，月经恢复时的体重与病前最大体重之间的差异更大。结论先前有饮食失调的超重患者与正常体重的同龄人的表现有所不同，因此依赖体重状态作为筛查标准可能会导致诊断不足。尽管先前超重的患者与月经恢复相关的BMI z评分较高，但与先前体重正常的患者相比，就诊和月经恢复之间体重增加和月经恢复时间没有差异。此外，对于以前超重的患者，月经恢复时体重明显低于病前最大体重，因此不必恢复到病前最大体重。