Anorexia nervosa, physical activity and nutrition: What potentiation?

Hyperactivity is often present in the symptoms of anorexia nervosa (AN). What impact does it have on the evolution and our understanding of these disorders? How do we take it into account in the care during the disorder's evolution? Physical activity (PA) in AN can become problematic, worsening prognosis by compromising the efficiency of care. The mechanisms contributing to this hyperactivity form a mosaic that includes highly various elements: one part is voluntary for weight loss purposes, another part is involuntary; it can be compulsive, controlled or not, with variable intensity, or completely inexistent. It seems that the more the disease becomes chronic, the more PA escapes from the subject's control. Depending on the moment and the individual, diverse mechanisms involved are responsible of the PA. According to the recommendations of medical treatment, care must take into account hyperactivity during AN with an approach including help to consciously acknowledge these symptoms and their character directly associated with the eating disorder, and this, in order for the patient and the care team to have as a common goal the progressive decrease of the PA's level. When a significant anxiety is associated with the withdrawal of this hyperactivity, an anxiolytic treatment could be proposed since anxiety promotes hyperactivity No molecule has demonstrated its effectiveness so far; sessions of adapted physical activity appear promising. (C) 2014 Elsevier Masson SAS. All rights reserved.