leptin and hyperactivity

One perplexing symptom of anorexia is the underfed person seems to have more energy than those around them. Parents are perplexed to discover an emaciated child with a compromised heart muscle secretly doing ab crunches in bed.

This is usually seen as just more proof of the person's "desire to be thin." I have always found that condescending implication of "vanity" an insult to sufferers. It says more about the rest of us and our unhealthy attitudes about appearance than it does about anorexia.

Compulsive exercise is clearly a biologically driven compulsion. It isn't a "want" but a "need."

One explanation is evolutionary: if someone in your tribe reacts to famine by running further and faster to get food, those genes are more likely to survive.

One mechanism for the phenomenon: The impact of hyperactivity and leptin on recovery from anorexia nervosa.

And this: more on the intriguing leptin connection.


  1. Laura,

    And I think that's part of the reason why AN is so powerful: it's a positive feedback loop. The more you exercise, the more weight you lose (or the more your energy balance gets out of whack), the lower your leptin gets, the more you are compelled to exercise, etc.

    What strikes me as interesting is that these low leptin levels appear to be a byproduct of starvation rather than a peculiar sort of biomarker particular to those with AN. So there's got to be something amiss with the regulatory system. Perhaps anorexics are more sensitive to leptin disturbances, or develop hypoleptinemia much more quickly.

    Trust me, you're not staying up to 3 am doing calisthenics because you want to. You're doing it to lose weight because that has become a primal need. Like the title of the book by Elizabeth Wurtzel (which I haven't read) "More, Now, Again". And I don't know what role the must-lose-weight plays in the biology, whether that's a symptom of our times or a core, biological symptom of AN. Does that make sense? Although, come to think of it, even if I were told what to eat and how much to exercise to optimize my weight loss, I wouldn't follow it. I'd go back to eating almost nothing and doing my rigid, ritualistic exercise routine. I think the justifications we tell ourselves are more culture-bound. I'm just being healthy, I wanna look like *her*, etc.

    I think I'm channeling Mary right now. :)

    Give my homeboy my fond regards.

  2. I'm fascinated - despite my reputation as a mechanistic drone - with that "culture-bound" part of it. My dad, early on in our life in Extreme Psychiatry, compared the body dysmorphia aspect of the illness to the "phantom limb" sensation in amputees. The mind must provide reasons for things - or take those provided by others. "I feel fat" is so readily and greedily agreed with in our society, or "I just want to be healthy." A brain searching for a way to dull the dissonance doesn't have to look far.

    In other cultures and times the answer was "god" or "spirits" or "sin."

    I think we'll soon understand all these mechanisms better. I sure hope so!

  3. The "phantom limb" makes a lot of sense. Or perhaps having a parasite or outside invader,like a bee on us, that we just want to shake but it won't go? So we try to out run it but we can't or in ana's case do as it says so it will shut up. It won't. It must be ignored away with new thoughts that the intelligent mind knows will heal it.

    I think we get a confusing message about vanity by what the media does to exploit those who are willing to sacrifice themselves to be a model. It may be a whole other sort of anorexia yet similar, as the person does see their pale starvation look as a form of beauty, something to strive for. It is disease but it's a disease which spreads it's word via one another in some places. It actually compares to others outside itself. How weird is that?

    Myself, I'll pray for a change! Science or the still unseen magical way...I won't discriminate. Science has failed me at times as we still can't "see" everything. I'd like for a new message in those racing minds of an ED sufferer, one that screams "you are perfect just as you are so please rest now". Hah! Take that ED.
    (I used to be afraid of saying perfect because of the links between perfectionism and mental illness...like it's a bad thing...but in the end it seems that "perfect" can be any old mess we want it to be. A perfect mess! It can mean doing quality work or even having a sloppy fun time....perfect)

  4. Mary,

    I love that way of looking at perfect!

    Perfect acceptance!

  5. I said something really profound and Blogger ate it. Grrr.

    Anyway, in a nutshell:

    I like the phantom limb idea. A lot.

    And Mary, we need to create a mini-Mary to hook onto a key chain that we can pull a string and says all of these really nice things (yes, I know we need to say them ourselves, too, but it's the concept!). Mine is going to be a big fuzzy, sparkly magic wand. /****



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