Metabolic Consequences in Anorexia Nervosa

  • Daniel Rigaud
  • Marie-Claude Brindisi


In anorexia nervosa (AN), weight loss and malnutrition trigger a cascade of metabolic, hormonal, and behavioral consequences. A considerable decrease in energy expenditure (EE) is observed during fasting states of the disease, but refeeding and weight gain induce a marked increase in EE, including an increase in resting EE, in diet-induced thermogenesis (DIT), and in EE related to physical activity. There is also a dramatic fall in protein catabolism and in glucose disposal during the fasting stages of the disease. During renutrition, these profiles become normal a long time before normalization of body weight. Malnutrition and slimming diets induce alterations in muscle mass and function, leading to difficulties in refeeding, for example by slowing gastric emptying. As shown in rats, the restrictive diet together with access to physical activity, which is secondary to anorectic thought, is responsible for increasing the cognitive restrictive diet and for increasing mental and physical hyperactivity. Energy and nutrient deficiencies are the consequence of fear of becoming obese, but could also induce, in one-third of cases, binge eating and, thus, purging. Recent studies have provided no evidence that AN is caused by neural, hormonal or metabolic factors and/or damage. But these metabolic and cognitive changes, which are mainly the consequence of the starvation, could explain some symptoms or behavior observed in AN, i.e., those related to the compulsive needs to remain thin and to the fear of being fat.


Physical Activity Eating Disorder Anorexia Nervosa Binge Eating Bulimia Nervosa 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Adrenocorticotropic hormone


Anorexia nervosa


Body mass index


Cholesterol ester transfer protein


Diet-induced thermogenesis


Eating disorder


Energy expenditure


Energy expenditure linked to physical activity


Energy expended for thermoregulation


Fat free mass


High density lipoprotein cholesterol


Insulin like growth factor 1


Low density lipoprotein cholesterol


Resting energy expenditure


Thyroid stimulating hormone


Very low density lipoprotein cholesterol


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© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of Endocrinology and NutritionCHU Le Bocage (Dijon University Hospital)Dijon CedexFrance

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