Vasoconstriction as a translational target in eating disorders: Autonomic dysregulation, insular mechanisms, and a novel multimodal detection system.

Eating disorders, particularly anorexia nervosa and atypical anorexia nervosa, collectively anorexia nervosa spectrum disorder, remain among the most lethal psychiatric conditions, with high relapse rates and limited effective treatments for adults. Autonomic dysregulation and interoceptive dysfunction have emerged as promising mechanistic contributors to symptom maintenance, yet no existing framework integrates these processes into a coherent, physiologically grounded model. This theoretical manuscript introduces vasoconstriction, the sympathetically mediated narrowing of peripheral blood vessels, as a mechanistically meaningful and underrecognized contributor to interoceptive, emotional, and behavioral disturbances in anorexia nervosa spectrum disorder. Vasoconstriction shapes the sensory evidence available to the insula, influences the clarity of hunger, thermal, and visceral cues, and may contribute to pathological exercise, emotion suppression, anxiety, and relapse vulnerability. To operationalize this construct, we present a multimodal vasoconstriction detector: a wearable-derived, z-scored composite of electrodermal activity, blood volume pulse amplitude, and peripheral temperature. Implemented in a LabVIEW/Python pipeline, the prototype detector provides a continuous index of vascular tone suitable for naturalistic monitoring. By integrating autonomic physiology, interoception science, and wearable-sensor methodology, this framework positions vasoconstriction as a theoretically coherent candidate biomarker that may illuminate mechanisms underlying anorexia nervosa spectrum disorder and support future translational work.