1. Heat in the treatment of patients with anorexia nervosa.

Eat Weight Disord.2001 Mar;6(1):49-52.

Gutierrez E, Vazquez R.


Departamento de Psicologia Clinica y Psicobiologia, Facultad de Psicologia, Campus Universitario Sur, Santiago de Compostela, Spain.


The paper presents the results of heat treatment in three cases of anorexia nervosa (AN), in which marked overactivity and/or strenuous exercising were prominent clinical features. Heat was supplied in three ways: continuous exposure to a warm environment, wearing a thermal waistcoat, and sauna baths in an infrared cabin. The outcomes went far beyond what had been expected, as the disappearance of hyperactivity was followed by progressive recovery.

2. Do people with anorexia nervosa use sauna baths? A reconsideration of heat-treatment in anorexia nervosa.

Eat Behav. 2002 Summer;3(2):133-42.

Gutierrez E1, Vazquez R, Beumont PJ.


First recommended by W. Gull, heat-treatment may be relevant to hyperactivity, a significant clinical characteristic in AN. This treatment was developed as an extrapolation from animal research model, where a simple manipulation of ambient temperature (AT) was found to impede and reverse excessive running in food-restricted rats. Sauna use may have been unreported either because it impedes the development of the syndrome, or its benefits have been attributed to conventional treatments. The elucidation of sauna experience among AN patients may have potential implications for the role of heat in the treatment of AN.

3. Heat makes a difference in activity-based anorexia: a translational approach to treatment development
in anorexia nervosa.

Int J Eat Disord. 2012 Jan;45(1):26-35. doi: 10.1002/eat.20884. Epub 2010 Nov 15.

Cerrato M, Carrera O, Vazquez R, Echevarría E, Gutierrez E.

Source: Departamento de Psicología Clinica y Psicobiología, Facultad de Psicología, Universidad de Santiago de Compostela, Santiago de Compostela, Spain.


Results: Warming activity-based anorexia animals reversed running activity, preserved food-intake, and enabled female rats to recover from acute weight loss. Moreover, sedentary food-restricted warmed rats maintained a body weight equivalent to the levels of animals housed at standard AT in spite of 20% reduced food-intake.

Discussion: The replication on female rats corroborates the effect previously reported for males, which is indicative of the robust effect of ambient temperature in recovering rats from activity-based anorexia.

The findings reported here represent strong preclinical evidence in favor of heat supply as a useful adjunctive component for the treatment of anorexia nervosa (AN).

4. Hyperactivity in anorexia nervosa: warming up not just burning-off calories.

PLoS One. 2012;7(7):e41851. doi: 10.1371/journal.pone.0041851. Epub 2012 Jul 27

Carrera O1, Adan RA, Gutierrez E, Danner UN, Hoek HW, van Elburg AA, Kas MJ.


Excessive physical activity is a common feature in Anorexia Nervosa (AN) that interferes with the recovery process. Animal models have demonstrated that ambient temperature modulates physical activity in semi-starved animals. The aim of the present study was to assess the effect of ambient temperature on physical activity in AN patients in the acute phase of the illness. Thirty-seven patients with AN wore an accelerometer to measure physical activity within the first week of contacting a specialized eating disorder center. Standardized measures of anxiety, depression and eating disorder psychopathology were assessed. Corresponding daily values for ambient temperature were obtained from local meteorological stations. Ambient temperature was negatively correlated with physical activity (p = -.405) and was the only variable that accounted for a significant portion of the variance in physical activity (p = .034). Consistent with recent research with an analogous animal model of the disorder, our findings suggest that ambient temperature is a critical factor contributing to the expression of excessive physical activity levels in AN.

Keeping patients warm may prove to be a beneficial treatment option for this symptom.