Assessment of Physical Activity Patterns in Adolescent Patients with Anorexia Nervosa and Their Effect on Weight Gain

Abstract

1) Background: Altered physical activity (PA) affects weight recovery in anorexia nervosa (AN) patients. The study aimed to objectively characterize PA patterns and their effect on weight trajectory in adolescent AN patients. (2) Methods: PA was assessed in 47 patients on admission to inpatient treatment, in n = 25 of these patients again 4 weeks after discharge (follow-up, FU), as well as in 20 adolescent healthy controls using the Sense Wear™ armband. The following PA categories were defined by metabolic equivalent (MET) ranges: sedentary behavior (SB), light (LPA), moderate (MPA), vigorous (VPA), and high-level PA (HLPA= MPA + VPA). (3) Results: LPA on admission was significantly higher in AN patients than in controls (103 vs. 55 min/d, p < 0.001), and LPA in AN decreased over time to 90 min/d (p = 0.006). Patients with higher admission LPA (n = 12) still had elevated LPA at FU (p = 0.003). High admission LPA was associated with a higher inpatient BMI percentage gain (∆BMI%; 18.2% ± 10.0% vs. 12.0% ± 9.7%, p = 0.037) but with a loss of ∆BMI% at FU (−2.3% ± 3.6% vs. 0.8% ± 3.6%, p = 0.045). HLPA at baseline was associated with a lower inpatient ∆BMI% (p = 0.045). (4) Conclusion: Elevated LPA in AN patients decreased after inpatient treatment, and PA patterns had an impact on weight trajectory.

Sensor technology in eating disorders research: A systematic review

“…Thirty‐three papers were identified that used sensors to measure physical activity levels and energy expenditure (see Table 1). The majority of studies used accelerometers to measure physical activity (Alberti et al, 2013; Belak et al, 2017; Bezzina et al, 2019; Bratland‐Sanda et al, 2011, 2012; Bratland‐Sanda, Sundgot‐Borgen, Ro, et al, 2010a; Bratland‐Sanda, Sundgot‐Borgen, Ro, et al, 2010b; Bratland‐Sanda, Sundgot‐Borgen, Rosenvinge, et al, 2010; Carrera et al, 2012; Duriez, Guy‐Rubin, et al, 2021; El Ghoch et al, 2013, 2016; Grosser et al, 2020; Hofmann et al, 2017; Holtkamp et al, 2006; Kemmer et al, 2020; Keyes et al, 2015; Klein et al, 2007; Kolar et al, 2020; Lampe et al, 2021; Langlet et al, 2021; Lehmann et al, 2018; Martinez‐Sanchez et al, 2020; Mathisen, Bratland‐Sanda, et al, 2018; Mathisen, Rosenvinge, et al, 2018; McDuffie, 1998; Sauchelli et al, 2015; Stengel et al, 2017; van Elburg et al, 2007; Wons et al, 2021; Zeeck et al, 2020). Other sensors utilized include pedometers (Blinder et al, 1970; Crandall, 2004), multi‐sensor full‐body systems including the Intelligent Device for Energy Expenditure and Activity and the Tracmor physical activity sensor system (Bouten et al, 1996; Gianini et al, 2016; Harris et al, 2008), and indirect calorimeter (Bouten et al, 1996; Harris et al, 2008).…”

Physical activity and sleep during the first week of anorexia nervosa inpatient care

“…In one such study, researchers found no significant effect of physical activity on recovery rates [ 21 ]. Meanwhile, a more recent study showed that patients with higher light physical activity at admission had a higher inpatient BMI percentage gain, but a loss of BMI percentage gain at follow-up [ 52 ]. A reason for these discrepancies could be different patient groups or treatments, but also differences in methods (i.e., activity metrics, body placement, devices and proprietary algorithms).…”

Might Starvation-Induced Adaptations in Muscle Mass, Muscle Morphology and Muscle Function Contribute to the Increased Urge for Movement and to Spontaneous Physical Activity in Anorexia Nervosa?

“…Once spontaneous physical activity levels, conceptualized as "daily physical activity not due to exercise" [59,60] and "all physical activity behavior that emanates from an inherent drive for movement" [61], were recorded in severely underweight AN patients, no differences were found in comparison to spontaneous physical activity levels in healthy normal weight subjects [9,46,62]. For a review of these studies, see [63].…”