Step 12:
Compensate for the Loss of Body Insulation
Understand How Significant Loss of Body Insulation is in Anorexia, and Take Steps to Compensate for it
Understanding the Problem
The subcutaneous layer of fat, which lies just under the skin, is extremely crucial to conserving body heat and calories1. It also contains the superficial blood vessels that bring blood to the surface where heat is exchanged2. When the subcutaneous fat layer is lost, as happens so rapidly in anorexia, the body becomes like an un-insulated house with the heater running and all the doors and windows open (Fig. 1). Even if food intake is restored to normal levels immediately, it will not supply enough energy to solve the problem. Just as far more fuel would be required to heat the un-insulated house with open windows than would be needed to heat a normally insulated home, so the energy (food) debt of the body without a subcutaneous layer will be very much larger than normal.
To make matters worse, as muscle tissue is broken down and utilized for energy in more advanced anorexia, the body loses one of its major heat sources. In normal individuals, muscle activity generates large amounts of heat which is distributed to other tissues via the bloodstream, helping to maintain normal body temperature3. Anorexia patients lose this important homeostatic mechanism, as well as that of their subcutaneous fat insulation. Individuals with anorexia are placed at a further thermal disadvantage as their bodies take on a thin shape with long thin appendages (arms and legs)