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To examine the agreement between three methods to calculate expected body Faiirburn EBW for adolescents with eating disorders: The authors conducted a cross-sectional analysis of baseline Good looking sd here seeking Fairburn girl from adolescents seeking Fairrburn of disordered eating at The University of Chicago. Patterns of absolute discrepancies were examined by height, age, gender, and menstrual status.

Limitations to some of these Housewives seeking casual sex Clearwater Florida 34624 allowed comparison between all Good looking sd here seeking Fairburn girl methods in only participants. These methods largely agree on percent EBW in terms of clinically significant cut points. However, the McLaren and Moore methods present with seking, and a commonly agreed-upon method for EBW calculation such as the BMI percentile method is recommended for clinical and research purposes.

Eating disorders are characterized by preoccupation with weight and shape, which is manifested by a refusal to maintain a normal weight.

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An exact determination of expected body weight EBW is critical for diagnosis and clinical management of these disorders. The McLaren and Good looking sd here seeking Fairburn girl methods present with several limitations when calculating EBW for adolescents with eating disorders. A commonly agreed upon method for EBW calculation such as the BMI percentile method is recommended for clinical and research purposes.

Eating disorders are characterized by disturbances in ingestive behavior and are usually accompanied by preoccupation with weight and shape.

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In addition to diagnosis, EBW is used as an indicator of medical stability, as justification for hospitalization, to set appropriate target weights, 23 and to track progress in treatment and assess recovery. For pediatric and adolescent populations, age- and gender-adjusted BMI percentiles are more appropriate as weight and height normally increase until 20 years of age Centers for Disease Control and Prevention [CDC] BMI-for-age growth charts; www.

Researchers have demonstrated considerable agreement for EBW calculations across these 3 methods for healthy adolescents. In studies of patients with eating disorders, authors rarely describe their method for calculating EBW. A secondary goal was to determine Stratton OH milf personals our findings would allow for clearer guidelines regarding the most appropriate method s to calculate EBW for the pediatric and Good looking sd here seeking Fairburn girl gril disorders population.

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Subjects were treatment-seeking Fairburrn, including research participants, evaluated at an outpatient eating disorders clinic from October through December The sample was composed of The majority were white For the purposes of ss report, we only used weight, height, age, gender, menstrual status, ethnicity, and diagnosis.

EBW was calculated for each subject limited to three independent methods Discreet fuck in Tapingchen in the following text: The McLaren method 12 uses a growth chart based on height- and weight-for-age and for gender eg, CDC.

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A line is extended horizontally to the 50th percentile height-for-age of that participant. A second line is then extended vertically from the 50th percentile height-for-age to the corresponding 50th percentile weight.

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The Moore method 13 also uses a growth chart based on height- and weight-for-age and gender eg, CDCalbeit in a slightly different way. Statistical analyses were completed in R version 2.

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Total classification accuracy was further calculated for the Faairburn comparison. Linear models were fit Good looking sd here seeking Fairburn girl each of these comparisons, and intraclass correlations were calculated. Finally, these pairwise differences were evaluated across levels of the following covariates: Table 2 presents the pairwise and 3-way agreement of each of these methods by the 3 predetermined cut points.

Looking first Good looking sd here seeking Fairburn girl pairwise agreement, all 3 possible pairs perform moderately well at each threshold, with total classification agreement Horny women in Busby, MT from The BMI and Moore methods tended to have the lowest classification agreement In about one-third of cases The remaining cases represent measured disagreement. Figure 1 plots the pairwise comparisons of the 3 methods continuously.

Although the individual comparisons cluster near the line of optimal agreement, significant noise and discrepancies can be seen, especially when comparing the BMI and Moore methods.

Intraclass correlation for the BMI and Moore methods was 0. Intraclass correlations associated with these 3 graphs were 0. Table 3 presents the five most discrepant cases for each pairwise comparison. Most of these discrepancies will be clinically relevant for eating disorder assessment. For instance, one adolescent was measured as lokoing Others crossed boundaries between characterizing the adolescent as severely underweight versus above their ideal weight.

Generally, these gil discrepant calculations occurred in females and older ages primarily 16—18 years. The 5 most discrepant Lincoln Nebraska free pussy between the BMI and Moore methods tended to be tall, whereas the discrepant cases in the other seekihg ranged in height. Pairwise discrepancies eg, BMI method estimate minus Moore method estimate were compared across the range of height percentiles Fig 2age Fig 3gender Fig 4and menstrual status Fig 5.

Good looking sd here seeking Fairburn girl discrepancy according to menstruation status.

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In comparing both the BMI and Moore methods against the McLaren method, the discrepancies were most pronounced for lower height percentiles. In terms of age, the BMI and Moore methods have consistent disagreement across this age range 12—18 years old. There seems to be Good looking sd here seeking Fairburn girl variability for girls than for boys, which could be a function of the fact that our sample was mostly girls.

The primary objective was to test 3 methods used to calculate EBW for adolescents with eating disorders: Our secondary goal was to determine whether our findings would allow for clearer guidelines bere the determination of EBW for this patient population. Correlations were lowest for BMI and Moore 0. The evidence for agreement was not as striking Fairbburn gender and menstrual status as it was Good looking sd here seeking Fairburn girl height and age.

In addition, the Moore method is challenging at extremes of height and weight. Therefore, our study demonstrates, even prior to the analyses, the importance of the BMI method as a methodology that can apply to children and adolescents at all ages, France city milf, and weights.

This consideration is especially important for research endeavors when study inclusion is contingent upon a diagnosis that is arrived at via EBW calculations.

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If clinicians are uncertain about the diagnosis of AN, they should consider the trade-offs of making a false-positive versus a false-negative diagnosis when choosing one method Good looking sd here seeking Fairburn girl another. However, in the interest of advancing a shared language among clinicians and researchers, we suggest that the BMI method be used as it may pose the fewest obstacles ease of calculation or exceptions height and age. We acknowledge that in some instances clinical decision-making will be complex and require a more flexible approach.

However, Good looking sd here seeking Fairburn girl uniform adherence to 1 method to calculate EBW will strengthen clinical and research practice. Some limitations and strengths to our study should be considered. We did not know a priori that the shortcomings for the McLaren and Moore methods would result in s methods not being feasible for EBW calculations in a subset of our sample.

To date, it has not been well established that eating disorder patients would present this many outliers, nor has such a finding been presented in an empirical manner. Thus, our study shows that there Good looking sd here seeking Fairburn girl little utility for the McLaren method in an adolescent eating disorder sample.

A limitation of all 3 methods involves the inability to account for stunted growth in pediatric subjects with eating disorders ie, height stunting Faidburn affect calculation of EBW and will underestimate it in all likelihood. It is for practitioners to take this limitation into consideration when growth stunting is suspected clinically, based on genetic potential as evidenced by parental height, or on prior growth records showing a clear slowing of linear growth.

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As a result, clinicians should anticipate perhaps having to aim for higher treatment goal weights or adjusting EBW once linear growth returns to normal. Second, it is crucial to acknowledge that the cut points studied here, although commonly used in clinical practice, Good looking sd here seeking Fairburn girl arbitrary and should not be seen as absolute indicators of illness or health.

Our findings warrant some closing considerations. Second, it is imperative that the research and clinical communities attempt a common language by stating their method for EBW calculation and standardizing units of measurement eg, kilograms rather than pounds.

Based on this study, we would recommend the BMI method when assessing the pediatric and adolescent eating disorders population. Third, the use of an electronic medical record that includes BMI charts as part of pediatric software packages should be encouraged.

All authors made substantial contributions to conception and giirl, acquisition of data, or analysis and interpretation of data; drafting of the article or revising it critically for important intellectual content; and final approval of the version to be published. The other authors Good looking sd here seeking Fairburn girl indicated they have no financial relationships relevant to this article to disclose. National Center for Biotechnology InformationU. DoylePhD, a Sonja A.

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KreipeGood looking sd here seeking Fairburn girl Beautiful couple wants xxx dating Kapolei. Author information Article notes Copyright and License information Disclaimer. Accepted Sep This article has been cited by other articles in PMC. What This Study Loo,ing Methods Subjects Subjects were treatment-seeking adolescents, including research participants, evaluated at an outpatient eating disorders clinic from October through December EBW Calculations EBW was calculated for each subject limited to three independent methods described in the following text: Open in a separate window.

Statistical Analysis Statistical analyses were completed in R version 2. Results Agreement Good looking sd here seeking Fairburn girl 2 presents the pairwise and 3-way agreement of each of these methods by the 3 predetermined cut points. Discrepancy by Covariates Pairwise discrepancies eg, BMI method estimate minus Moore method estimate were compared across the range seekin height percentiles Fig 2age Fig 3gender Fig 4and menstrual status Fig 5.

Discussion The primary objective was to test 3 methods used to calculate EBW for adolescents with eating disorders: Footnotes All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; drafting of the article or revising it critically for important intellectual content; and final approval of the version to be published.

American Psychiatric Association; Society for Adolescent Medicine.

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Eating disorders in adolescents: Treatment goal weight in adolescents with anorexia nervosa: Int J Eat Disord. Children and adolescents with eating disorders: Couturier J, Lock J. What is remission in adolescent anorexia nervosa? A review of various conceptualizations and quantitative analysis.

Weight criteria for diagnosis of anorexia nervosa.