Why Feeling Cold Can Be a Dangerous Sign in Anorexia Nervosa

By: Jennifer L. Gaudiani, MD, CEDS

Monday, December 21, 2015

Happy Monday friends! Once again, I’m going to discuss a topic that can help you combat the “I’m Fine Syndrome” – a term we at the ACUTE Center for Eating Disorders use to explain when a patient is in denial about the severity of his or her eating disorder. The subject is temperature regulation, and this one isn’t about life-threatening medical complications so much as it is about knowing your body when you’re in your disorder so that you can use good objective evidence of body suffering with your wise mind in order to combat the mean lies and distortions that your eating disorder whispers to you.

When you’re not eating enough, your “cave girl brain” (the one responsible for controlling body processes and species survival) assumes that you must be in famine, so she sets to work doing everything in her power to keep you alive. She starts by slowing your metabolism way down and does this by turning down your inner furnace – aka: your body temperature.

For example, in the winter, in order to save money on your energy bill, you might turn down the thermostat in your house or close some of the vents in your room. That is exactly what your cave girl brain does with your body temperature. Patients who aren’t eating enough run chilly body temperatures and lack consistent flow of warm, calorie-heated blood to their hands and feet (or using our example, the rooms that are less important). Not only does your body cool its thermostat and shut off warm blood to the extremities, but it also grows extra fine, soft hair, most visible on the face. This hair is called lanugo, and it has literally been regrown to try and keep you warm by holding in heat, as if you are growing a pelt. 

Remember: typically in mammals, the normal body temperature of 98.6 degrees is maintained as top priority because mammals’ body enzymes depend on this normal temperature in order to function correctly. So to start running cold is a sign that your body is suffering severely from caloric deprivation. Chilly all the time? Cool, sometimes blue-ish hands and feet? Fuzzy face? Things aren’t going well!

The irony is that chronic caloric deprivation, with or without over-exercise or purging, puts your body into extreme metabolic hibernation. Amazingly, eating enough and resting your body within the first two or so weeks will NOT cause weight gain but rather will all go towards speeding up your metabolism! It’s the opposite of what your eating disorder voice tells you and trust me, I have seen this for years and each time my patients are amazed.  It’s what we see on ACUTE all the time. Your heart rate increases, your body temperature warms up, as do your hands and feet, all before any weight is gained. 

So, when your eating disorder voice begins to tell you that you “are fine”, remember these facts. Nourish your body and you will be on your way to living a healthier and happier life. Take care, and stay warm.

*Note: the risk of refeeding syndrome is significant and caloric increases must be carefully monitored. For more information on refeeding syndrome and its potentially fatal complications, click here

If you or a loved one is suffering from an eating disorder, do not delay seeking treatment. We at the ACUTE Center for Eating Disorders are here to help. For more information or to take a confidential assessment, please contact our admissions team at acuteinfo@dhha.org or by calling our admissions line at 1-877-ACUTE-4-U.