Exercise in the care of patients with anorexia nervosa: A systematic review of the literature

Anorexia Nervosa (AN) is difficult to treat and rates of patient relapse are high. The poor clinical prognosis of AN should encourage researchers and clinicians to consider alternative treatment approaches. Aim: The aim of this article was to review literature on the impact of exercise training interventions for patients living with AN. Method: Following methodological guidelines outlined by the Cochrane Library, a systematic review of the literature was undertaken on the role of exercise in AN. Findings: The incorporation of exercise into treatment for patients with AN does not have a detrimental impact on body mass index (BMI) or eating disorder symptoms. Exercise also appears to enhance quality of life, psychological wellbeing, and compliance to treatment. Only minimal improvements in fitness and strength were noted, possibly due to insufficient training loads of short duration and small sample sizes. Exercise is feasible and acceptable for patients. Discussion: Evidenced based recommendations for the healthful incorporation of activity into treatment for patients with AN and directions for future research, are proposed. Since nutritionally supported exercise training interventions for medically stable patients with AN appear to be safe, clinicians and researchers may want to consider exercise as an important facet of care. (C) 2013 Elsevier Ltd. All rights reserved.