Exercise in Eating Disorders Treatment: Systematic Review and Proposal of Guidelines.

Brian J Cook, Stephen A Wonderlich, James E Mitchell, Ron Thompson, Roberta Sherman, Kimberli McCallum
Author Information
  1. Brian J Cook: 1California State University Monterey Bay, Seaside, CA; 2Neuropsychiatric Research Institute, Fargo, ND; 3University of North Dakota School of Medicine and Health Sciences, Fargo, ND; 4Indiana University, Bloomington, IN; 5Bloomington, IN; and 6The Victory Program at McCallum Place, St. Louis, MO.

Abstract

INTRODUCTION: Although exercise is an effective intervention for many psychological health issues, it has often been overlooked as a potential adjunct to eating disorder (ED) treatment. Thus, our objective was to summarize the literature by synthesizing themes identified in clinical studies and explicit guidelines or recommendations for the use or management of exercise in ED interventions into a proposed set of guidelines for the use of exercise in ED treatment.
METHODS: A literature search in exercise science, health psychology, and the ED literature was conducted. The focus was to obtain articles that reported on therapeutic effects and/or guidelines for the therapeutic use of exercise in individuals with ED.
RESULTS: Our review identified 11 core themes describing techniques that have been successful in using exercise therapeutically in ED treatment. These 11 guidelines are as follows: employ a team of relevant experts, monitor medical status, screen for exercise-related psychopathology, create a written contract of how therapeutic exercise will be used, include a psychoeducational component, focus on positive reinforcement, create a graded exercise program, begin with mild-intensity exercise, tailor the mode of exercise to the needs of the individual, include a nutritional component, and debrief after exercise sessions.
CONCLUSION: Our review identifies specific guidelines that may enhance ED treatment outcomes. It is the first to summarize divergent literature and synthesizes previous successes that may guide the use of therapeutic exercise in some, but not all ED patients. This review provides a practical set of guidelines for the clinical management and therapeutic use of exercise in ED treatment by focusing on empowering individuals with exercise as a tool for healthy living.

References

  1. Appl Physiol Nutr Metab. 2011 Jul;36 Suppl 1:S113-53 [PMID: 21800939]
  2. Qual Life Res. 2011 Nov;20(9):1385-90 [PMID: 21384263]
  3. Med Sci Sports Exerc. 2002 Feb;34(2):190-5 [PMID: 11828224]
  4. Int J Eat Disord. 2005 Jul;38(1):24-9 [PMID: 15991218]
  5. J Athl Train. 2008 Jan-Mar;43(1):80-108 [PMID: 18335017]
  6. Int J Eat Disord. 2014 Sep;47(6):601-9 [PMID: 24810684]
  7. Med Sci Sports Exerc. 2011 Jul;43(7):1334-59 [PMID: 21694556]
  8. Int J Sports Med. 2006 Aug;27(8):660-5 [PMID: 16874594]
  9. Physiotherapy. 2013 Mar;99(1):1-11 [PMID: 23219634]
  10. Psychother Psychosom Med Psychol. 2012 Dec;62(12):456-62 [PMID: 23247620]
  11. J Clin Epidemiol. 2009 Oct;62(10):1006-12 [PMID: 19631508]
  12. Int J Eat Disord. 2014 Apr;47(3):268-72 [PMID: 24136170]
  13. Percept Mot Skills. 2012 Oct;115(2):618-31 [PMID: 23265023]
  14. Int J Eat Disord. 2010 Apr;43(3):266-73 [PMID: 19839057]
  15. J Prev Med Public Health. 2013 Jan;46 Suppl 1:S12-21 [PMID: 23412549]
  16. Eat Weight Disord. 1997 Dec;2(4):207-10 [PMID: 14655829]
  17. Int J Eat Disord. 2007 Jul;40(5):446-53 [PMID: 17497709]
  18. J Health Psychol. 2008 May;13(4):495-502 [PMID: 18420757]
  19. Psychol Bull. 2002 Sep;128(5):825-48 [PMID: 12206196]
  20. Am J Psychiatry. 1970 Feb;126(8):1093-8 [PMID: 5411363]
  21. Int J Eat Disord. 2004 Mar;35(2):155-60 [PMID: 14994352]
  22. Am Fam Physician. 2003 Jan 15;67(2):297-304 [PMID: 12562151]
  23. Eat Behav. 2003 Mar;4(1):79-88 [PMID: 15000989]
  24. Cardiology. 2011;120(4):217-20 [PMID: 22343463]
  25. Int J Eat Disord. 2011 Nov;44(7):579-84 [PMID: 21997420]
  26. Int J Eat Disord. 2009 Sep;42(6):571-4 [PMID: 19172600]
  27. Eur Eat Disord Rev. 2011 May-Jun;19(3):216-25 [PMID: 21584914]
  28. Eur Eat Disord Rev. 2011 May-Jun;19(3):174-89 [PMID: 21584911]
  29. Exerc Sport Sci Rev. 2008 Jan;36(1):43-7 [PMID: 18156953]
  30. Int J Eat Disord. 2010 Nov 1;43(7):611-8 [PMID: 19806608]
  31. Int J Eat Disord. 2000 Jul;28(1):101-6 [PMID: 10800019]
  32. Int J Eat Disord. 2009 Mar;42(2):97-103 [PMID: 18951455]
  33. J Womens Health (Larchmt). 2003 May;12(4):331-40 [PMID: 12804340]
  34. Eat Disord. 2004 Winter;12(4):273-91 [PMID: 16864521]
  35. Eur Arch Psychiatry Clin Neurosci. 2011 Nov;261 Suppl 2:S186-91 [PMID: 21935629]
  36. Disabil Rehabil. 2014;36(8):628-34 [PMID: 23826882]
  37. Eat Behav. 2015 Jan;16:9-12 [PMID: 25464059]
  38. J Sports Sci. 2011 Jul;29(10 ):1001-10 [PMID: 21644168]

Grants

  1. T32 MH082761/NIMH NIH HHS

MeSH Term

Exercise Therapy
Feeding and Eating Disorders
Humans
Practice Guidelines as Topic

Word Cloud

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