How and Why to Add Autonomic Phenotyping and Autonomic Balancing Interventions Into Eating Disorder Treatment.

Autonomic assessment has traditionally been used for cardiovascular evaluation, but its applications extend into the field of eating disorders and psychiatry at large. By measuring heart rate, heart rate variability, and electrodermal activity with wearable sensor technology, one can observe state and trait adaptive responses of the parasympathetic and sympathetic nervous systems. Individuals on the anorexia and atypical anorexia nervosa spectrum often present with high heart rate variability, conventionally considered cardioprotective, yet likely maladaptive in these disorders. With this phenotype, it may be advantageous to employ a unique, yet logical therapeutic strategy of enhancing sympathetic response while reducing parasympathetic response. With the integration of autonomic phenotyping (i.e., aggregating psychophysiological indices), data-driven idiographic treatment approaches have the potential to go beyond choosing the most effective psychotherapy for an individual. Determining individual autonomic phenotypes, regardless of eating disorder diagnosis, can augment other idiographic outcomes to inform treatment options and monitor progression of the disorder.