Hyperactivity in anorexia nervosa: to warm or not to warm. That is the question (a translational research one)

In the Editorial ‘Is the neglect of exercise in anorexia nervosa research a case of “running out” of ideas or do we need to take a “LEAP” of faith into the future?’ these authors express their doubts concerning the suitability of keeping patients warm as a beneficial treatment option in managing excessive activity in anorexia nervosa (AN) patients. The case for warming as an adjunctive treatment for AN patients is based on strong experimental evidence gathered from research on animals with Activity-Based Anorexia (ABA). We posit that the beneficial effect of heat results, at least in part, from heat blocking the vicious cycle that hyperactivity plays on AN. Hyperactivity decreases caloric intake by interfering with feeding and increases energy expenditure through excess motor activity which in turn increases emaciation that further strengthens anorexic thinking.