Physiological and Physical Analysis in Anorexia Nervosa (AN) in-patients

The research, in the field of Adapted Physical Activity (APA) in Anorexia Nervosa (AN), have investigated the effects of cognitive, behavioral and nutritional therapy (CBT) on: (i) Body Composition, (ii) Energy Expenditure and (iii) Physical Capacities (PC) in AN in-patients. The research involved subjects with Anorexia Nervosa, admitted in Villa Garda Hospital – Department of Eating Disorder and Obesity – Garda, Verona, between 2010 and 2012. Patients were included if they met the following criteria: (i) age, 12-65 years; (ii) diagnosis of AN assessed by Eating Disorders Examination interview (EDE) 12.0D); (iii) failure of less intensive outpatient treatment or an eating disorder of such clinical severity as to be unmanageable in an outpatient setting. Subjects with active substance abuse and acute psychotic disorders were not considered for hospital admission. The research study was divided into three sections. The first section contains definitions and scientific background of eating disorders and anorexia nervosa in particular, together with its related psychopathologies, and treatment. The second section describes the physiology of Eating Disorder, Anorexia Nervosa in particular, and providing, at the conclusion of the section, the three published studies dealing with basal metabolism and body composition in the experimental group of patients at Villa Garda Hospital. The third section is devoted to physical activity related to Eating Disorders, especially Anorexia Nervosa. In the conclusion of this section, study 4 and 5 propose an innovative measurement of health related physical capacities and approach to new methodology for objective measurement of the quantity and quality of physical activity, in clinical context. Conclusions: REE expenditure in underweight AN patients may be estimate with discrete accuracy, after just one day of refeeding, by the FitMate method, and by the Müller et al. equation. The SenseWear Pro2 Armband (SWA) does not appear to be an alternative to the FitMate and Müller equation methods for the assessment of REE in patients with AN. The skinfold thicknesses (ST) method underestimated %BF when compared with DXA. The Eurofit Physical Fitness Test Battery (EPFTB) is a feasible field battery of tests for assessing physical fitness in AN patients; the weight restoration improves physical fitness in patients with AN; after weight restoration, AN patients, however, show lower physical fitness than age-matched non-trained controls. Measured light physical activity (LPA) seems to be a good predictor of the out-come of the treatment; AN patients spent significantly longer periods in activity classified as sedentary and light, compared to activities classified as moderate or vigorous; IPAQ significantly underestimated PA with respect to actiheart (AH).