title: Physical activity in anorexia nervosa: How relevant is it to therapy response?
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.
  
  
  METHODS
  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.
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907 Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Sauchelli
authors.affiliation: Eating Disorders Service, Glenfield University Hospital, Leicester NG1 5BH, United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: Arcelus
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907 Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Sánchez
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907 Barcelona, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Riesco
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907 Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, 08036 Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Jiménez-Murcia
authors.affiliation: CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain; Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Granero
authors.affiliation: Department of Psychiatry, Psychology and Psychosomatic Medicine, Hospital Universitario Quirón Dexeus, 08028 Barcelona, Spain.
authors.forename: K
authors.initials: K
authors.lastname: Gunnard
authors.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, 46010 Valencia, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Baños
authors.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, 12071 Castelló, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Botella
authors.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), 08003 Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, 08002 Barcelona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: de la Torre
authors.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, 29010 Málaga, Spain.
authors.forename: J C
authors.initials: JC
authors.lastname: Fernández-García
authors.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, 17007 Girona, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Fernández-Real
authors.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, 31008 Pamplona, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Frühbeck
authors.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, 31008 Pamplona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Gómez-Ambrosi
authors.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, 29010 Málaga, Spain.
authors.forename: F J
authors.initials: FJ
authors.lastname: Tinahones
authors.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, 15706 Santiago de Compostela, Spain.
authors.forename: F F
authors.initials: FF
authors.lastname: Casanueva
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907 Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Menchón
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907 Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, 08036 Barcelona, Spain. Electronic address: ffernandez@bellvitgehospital.cat.
authors.forename: F
authors.initials: F
authors.lastname: Fernandez-Aranda
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications / Q000523:psychology / Q000628:therapy*; D003863:Depression / Q000150:complications / Q000523:psychology / Q000628:therapy*; D015444:Exercise; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology; D008297:Male; D009043:Motor Activity; D017060:Patient Satisfaction; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anorexia nervosa; Depression; Partial hospitalization; Physical activity; Treatment outcome