Effect of dronabinol therapy on physical activity in anorexia nervosa: a randomised, controlled trial

Original Article

Abstract

Purpose

The level of physical activity is inappropriately high in up to 80 % of the patients suffering of anorexia nervosa (AN), as a result of conscious efforts to lose weight, affect regulation and biological adaptive changes to starvation induced by hypothermia and neuroendocrine mechanisms. The purposes of this paper were to (1) assess the effect of dronabinol—a synthetic cannabinoid agonist—on physical activity in patients with chronic and stable AN, and to (2) unravel the role of leptin and cortisol in this process.

Methods

This prospective, randomised, double-blind, crossover study was conducted at a specialised care centre for eating disorders. Twenty-four adult women with AN of at least 5-year duration received either the dronabinol-placebo or placebo-dronabinol sequence. Physical activity was monitored during the fourth week of each intervention. Body weight, leptin and urinary free cortisol excretion were measured repeatedly during the trial. Changes in behavioural dimensions related to AN were assessed by Eating Disorder Inventory-2.

Results

The total duration of physical activity did not change, while its average intensity increased by 20 % (P = 0.01) during dronabinol therapy, resulting in an increased energy expenditure with 68.2 kcal/day (P = 0.01) above placebo.

Conclusions

This randomised, double-blind study revealed that cannabinoid agonist treatment was associated with a modest increase in physical activity in adult women with severe and longstanding AN. Additionally, we detected a strong relationship between the circulating levels of leptin and physical activity in these chronically undernourished patients.

Keywords

Anorexia nervosa Physical activity Urinary free cortisol Leptin Dronabinol 

Notes

Acknowledgments

We thank the patients who participated in the trial; Charlotte Olsen, Lone Hansen and Merete Møller are thanked for helping with collecting samples and the leptin measurements. We would like to kindly thank to the team at the Department of Exercise epidemiology, University of Southern Denmark who developed the software Propero used for compiling accelerometer data. Claire Gudex is thanked for language editing of the manuscript.

Conflict of interest

None.

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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Alin Andries
    • 1
    • 2
  • Bibi Gram
    • 3
    • 4
  • René Klinkby Støving
    • 1
    • 2
  1. 1.Department of Endocrinology, Centre for Eating DisordersOdense University HospitalOdenseDenmark
  2. 2.Psychiatry of Region Southern DenmarkUniversity of Southern DenmarkOdenseDenmark
  3. 3.Department of Clinical ResearchHospital of Southwest DenmarkEsbjergDenmark
  4. 4.Institute of Regional Health ResearchUniversity of Southern DenmarkOdenseDenmark

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