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Physical activity in anorexia nervosa: How relevant is it to therapy response?

Published online by Cambridge University Press:  21 October 2015

S. Sauchelli ,
J. Arcelus ,
I. Sánchez ,
N. Riesco ,
S. Jiménez-Murcia ,
R. Granero ,
K. Gunnard ,
R. Baños ,
C. Botella  and
R. de la Torre
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S. Sauchelli
Affiliation:
Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907Barcelona, Spain CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
J. Arcelus
Affiliation:
Eating Disorders Service, Glenfield University Hospital, NG1 5BHLeicester, United Kingdom
I. Sánchez
Affiliation:
Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907Barcelona, Spain
N. Riesco
Affiliation:
Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907Barcelona, Spain
S. Jiménez-Murcia
Affiliation:
Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907Barcelona, Spain CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain Department of Clinical Sciences, School of Medicine, University of Barcelona, 08036Barcelona, Spain
R. Granero
Affiliation:
CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, 08193Barcelona, Spain
K. Gunnard
Affiliation:
Department of Psychiatry, Psychology and Psychosomatic Medicine, Hospital Universitario Quirón Dexeus, 08028Barcelona, Spain
R. Baños
Affiliation:
CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain Department of Psychological, Personality, Evaluation and Treatment of the University of Valencia, 46010Valencia, Spain
C. Botella
Affiliation:
CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain Department of Basic Psychology, Clinic and Psychobiology of the University Jaume I, 12071Castelló, Spain
R. de la Torre
Affiliation:
CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain Human Pharmacology and Clinical Neurosciences Research Group, Neuroscience Research Program, IMIM (Hospital del Mar Medical Research Institute), 08003Barcelona, Spain Department of Experimental and Health Sciences, Universitat Pompeu Fabra, 08002Barcelona, Spain
J.C. Fernández-García
Affiliation:
CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain Department of Diabetes, Endocrinology and Nutrition, Hospital Clínico Universitario Virgen de Victoria, 29010Málaga, Spain
J.M. Fernández-Real
Affiliation:
CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain Department of Diabetes, Endocrinology and Nutrition, Institut d’Investigació Biomèdica de Girona (IdlBGi), Hospital Dr Josep Trueta, 17007Girona, Spain
G. Frühbeck
Affiliation:
CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, University of Navarra, 31008Pamplona, Spain
J. Gómez-Ambrosi
Affiliation:
CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, University of Navarra, 31008Pamplona, Spain
F.J. Tinahones
Affiliation:
CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain Department of Diabetes, Endocrinology and Nutrition, Hospital Clínico Universitario Virgen de Victoria, 29010Málaga, Spain
F.F. Casanueva
Affiliation:
CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain Department of Medicine, Endocrinology Division, Santiago de Compostela University, Complejo Hospitalario Universitario, 15706Santiago de Compostela, Spain
J.M. Menchón
Affiliation:
Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907Barcelona, Spain CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
F. Fernandez-Aranda*
Affiliation:
Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907Barcelona, Spain CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain Department of Clinical Sciences, School of Medicine, University of Barcelona, 08036Barcelona, Spain
*
⁎Corresponding author at: Department of Psychiatry and CIBERObn, University Hospital of Bellvitge-IDIBELL, c/Feixa Llarga s/n, 08907 Barcelona, Spain. Tel.: +34 93 2607227; fax: +34 93 2607193. E-mail addresses: [email protected], [email protected] (F. Fernandez-Aranda).
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Abstract

Objective

Elevated physical activity has been observed in some patients with anorexia nervosa (AN) despite their emaciated condition. However, its effects on treatment outcome remain unclear. This study aimed to examine objectively measured physical activity in this clinical population and how it might be related to a partial hospitalization therapy response, after considering potential confounders.

Method

The sample comprised 88 AN patients consecutively enrolled in a day hospital treatment program, and 116 healthy-weight controls. All participants were female and a baseline assessment took place using an accelerometer (Actiwatch AW7) to measure physical activity, the Eating Disorders Inventory-2 and the Depression subscale of the Symptom Checklist-Revised. Outcome was evaluated upon the termination of the treatment program by expert clinicians.

Results

Although AN patients and controls did not differ in the average time spent in moderate-to-vigorous physical activity (MVPA) (P = .21), nor daytime physical activity (P = .34), fewer AN patients presented a high physical activity profile compared to the controls (37% vs. 61%, respectively; P = .014). Both lower levels of MVPA and greater eating disorder severity had a direct effect on a poor treatment outcome. Depression symptoms in the patients were associated with lower MVPA, as well as with an older age, a shorter duration of the disorder and greater eating disorder psychopathology.

Conclusions

There is a notable variation in the physical activity profile of AN patients, characterized by either low or very high patterns. Physical activity is a highly relevant issue in AN that must be taken into account during the treatment process.

Keywords

Physical activityAnorexia nervosaTreatment outcomeDepressionPartial hospitalization
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 8 , November 2015 , pp. 924 - 931
Copyright
Copyright © European Psychiatric Association 2020

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