{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T07:52:17Z","timestamp":1790495537165,"version":"4.1.0"},"reference-count":51,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T00:00:00Z","timestamp":1666742400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fondation de l\u2019Avenir","award":["AP-RMA-16-040"],"award-info":[{"award-number":["AP-RMA-16-040"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Introduction: Body image distortion is a core symptom of anorexia nervosa (AN), embodying dissatisfaction and overvaluation of body appearance and weight. Body image distortion is an important factor in the maintenance of weight loss behaviours such as compulsive physical exercise. Conversely, physical exercise seems to have an aggravating effect on body image in patients with AN, but the evidence is still poor. The aim of this study was to examine the relationship between body image distortion and physical exercise in AN in order to understand whether physical exercise may play a specific role in body image distortion beyond psychopathological severity. Methods: Forty patients with AN and 21 healthy controls were tested for body image distortion and different proxies of physical exercise. Univariate correlations tested the relationship between body image distortion and physical exercise in AN and control groups. Then, to experimentally assess the effect of exercise on body image distortion, participants were invited to rate their body image before and after a standardised effort test. Results: In the AN group, a correlation was found between physical activity and body image distortion (p &lt; 0.01), which was still significant after controlling for psychopathological severity. No correlation was found in healthy controls. After a standardised effort, patients with AN had higher increases in body image distortion than healthy controls (almost 4 kg\/m2 vs. 0.8 kg\/m2) (p &lt; 0.01). Discussion: Physical exercise may contribute to the distortion of body image in anorexia nervosa and explain the paradoxical augmentation of unhealthy exercise despite ongoing weight loss.<\/jats:p>","DOI":"10.3390\/nu14214507","type":"journal-article","created":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T11:53:51Z","timestamp":1666785231000},"page":"4507","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The Fitter I Am, the Larger I Feel\u2014The Vicious Circle of Physical Exercise in Anorexia Nervosa"],"prefix":"10.3390","volume":"14","author":[{"given":"Laura","family":"Di Lodovico","sequence":"first","affiliation":[{"name":"Clinique des Maladies Mentales et de l\u2019Enc\u00e9phale (CMME), H\u00f4pital Sainte-Anne, GHU Paris Psychiatrie et Neurosciences, 75014 Paris, France"},{"name":"Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Universit\u00e9 Paris Cit\u00e9, 75006 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7228-8723","authenticated-orcid":false,"given":"Mouna","family":"Hanachi","sequence":"additional","affiliation":[{"name":"Nutrition Unit, Paul Brousse University Hospital, Assistance Publique\u2013H\u00f4pitaux de Paris, 94800 Villejuif, France"},{"name":"Micalis Institute, INRA, AgroParisTech, Universit\u00e9 Paris-Saclay, 78350 Jouy-en-Josas, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7321-6820","authenticated-orcid":false,"given":"Philibert","family":"Duriez","sequence":"additional","affiliation":[{"name":"Clinique des Maladies Mentales et de l\u2019Enc\u00e9phale (CMME), H\u00f4pital Sainte-Anne, GHU Paris Psychiatrie et Neurosciences, 75014 Paris, France"},{"name":"Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Universit\u00e9 Paris Cit\u00e9, 75006 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1845-3676","authenticated-orcid":false,"given":"Philip","family":"Gorwood","sequence":"additional","affiliation":[{"name":"Clinique des Maladies Mentales et de l\u2019Enc\u00e9phale (CMME), H\u00f4pital Sainte-Anne, GHU Paris Psychiatrie et Neurosciences, 75014 Paris, France"},{"name":"Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Universit\u00e9 Paris Cit\u00e9, 75006 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1016\/S2215-0366(15)00356-9","article-title":"Anorexia nervosa: Aetiology, assessment, and treatment","volume":"2","author":"Zipfel","year":"2015","journal-title":"Lancet Psychiatry"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1016\/j.biopsych.2012.04.025","article-title":"Disruption of Visuospatial and Somatosensory Functional Connectivity in Anorexia Nervosa","volume":"72","author":"Favaro","year":"2012","journal-title":"Biol. 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