Anorexia Nervosa (AN) is a severe and complex eating disorder. While patients often turn to compulsive exercise as means for weight control, starvation intensifies the urge to move, leading to increased restlessness. Despite advancements in AN, interventions often overlook the crucial role of drive for activity in reinforcing the eating disorder. Our study aimed to test feasibility and effectiveness of a Virtual Reality (VR) Running protocol to target the acute urge to be physically active. A 23-year-old female inpatient with severe AN, participated in a 4-week VR Running protocol, involving six sessions of simulated jogging in a VR environment. Pre- and post-intervention assessments, with a follow-up after one week, evaluated psychopathological and trait- and addictive physical activity measures. Although treatment outcomes were only partially achieved and there was little change observed in clinical parameters such as weight and body-mass index, notable reductions in the acute urge for physical activity were observed after each VR session. Subjective scores also indicated a decreasing trend in the urge to move during sessions. Additionally, reliable and clinically relevant changes were observed in interoceptive deficits and emotion regulation. This study represents a first attempt to develop a structured VR running protocol targeting the acute urge to be physically active in severe AN and integrating such interventions into a rehabilitation program for eating disorders. Future research involving longer exposures and controlled clinical trials is necessary to refine the VR-based protocol and evaluate its clinical and therapeutic efficacy.