{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:32:38Z","timestamp":1780471958421,"version":"3.54.1"},"reference-count":185,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T00:00:00Z","timestamp":1698192000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Behav. Neurosci."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To clarify the association between acute anorexia nervosa (AN) and semi-starvation (SS) by focusing on similarities and differences in physiology, mood, and behavior.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A comparison of published literature between these two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both groups show similar hormonal and metabolic changes in response to caloric restriction and extreme weight loss (~25%). Associated changes result in a reduced body temperature (T<jats:sub>core-low<\/jats:sub>). Maintenance of body temperature within a specific range is crucial to survival. However, both groups cannot activate autonomic strategies to maintain their T<jats:sub>core-low<\/jats:sub>, such as increasing metabolic rate, constricting skin blood vessels, or shivering. Furthermore, T<jats:sub>core-low<\/jats:sub> increases the individuals\u2019 \u201ccoldness sensations\u201d throughout the body, hence the frequent reports from ANs and SSs of \u201cfeeling cold.\u201d To eliminate these uncomfortable \u201ccoldness sensations\u201d and, importantly, to maintain T<jats:sub>core-low<\/jats:sub>, ANs, and SSs <jats:italic>\u201cselect\u201d different thermoregulatory behavioral strategies<\/jats:italic>. It is proposed that the <jats:italic>primary differences<\/jats:italic> between AN and SS, based on genetics, now manifest due to the \u201cselection\u201d of different thermo-regulatory behaviors. AN patients (ANs) \u201cselect\u201d hyperactive behavior (HyAc), which increases internal metabolic heat and thus assists with maintaining T<jats:sub>core-low<\/jats:sub>; in harmony with hyperactive behavior is a lively mood. Also related to this elevated arousal pattern, ANs experience disrupted sleep. In contrast, SS individuals \u201cselect\u201d a passive thermo-behavioral strategy, \u201cshallow torpor,\u201d which includes reduced activity, resulting in energy conservation. In addition, this inactivity aids in the retention of generated metabolic heat. Corresponding to this lethargic behavior, SS individuals display a listless mood and increased sleep.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Initial <jats:italic>similarities<\/jats:italic> between the two are attributable to physiological changes related to extreme weight loss. <jats:italic>Differences<\/jats:italic> are most likely attributable to genetically programmed \u201cselection\u201d of alternate thermoregulatory strategies, primarily to maintain T<jats:sub>core-low<\/jats:sub>. However, if acute AN is prolonged and evolves into a chronic condition, AN will more closely align with starvation and more precisely reflect SS symptomology.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnbeh.2023.1243572","type":"journal-article","created":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T05:10:55Z","timestamp":1698297055000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Similarities and differences regarding acute anorexia nervosa and semi-starvation: does behavioral thermoregulation play a central role?"],"prefix":"10.3389","volume":"17","author":[{"given":"Lucille Lakier","family":"Smith","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1038\/382250a0","article-title":"Role of leptin in the neuroendocrine response to fasting","volume":"382","author":"Ahima","year":"1996","journal-title":"Nature"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1643","DOI":"10.1249\/MSS.0b013e31828e8f07","article-title":"Assessment of physical activity in anorexia nervosa and treatment outcome","volume":"45","author":"Alberti","year":"2013","journal-title":"Med. 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