Journal Article

Medical and physiological complications of exercise for individuals with an eating disorder: a narrative review

Reilly, Alanah, Fernández del Valle, María, Calogero, Rachel M, Quesnel, Danika A, Cooper, Marita

2023

Overview

Individuals with eating disorders (ED) experience prolonged malnutrition, binge episodes, and compensatory behaviours that affect every organ system. Psychological and physiological symptoms are worsened with comorbid dysfunctional exercise, seen in up to 80% of those with an ED. Although return to exercise is an important component of treatment and recovery, little is known about the contraindications and risks of exercise engagement specific to those with an ED. This paper provides a comprehensive narrative review of the medical and physiological complications of engaging in exercise during ED treatment and outlines when exercise may be contraindicated or used in modified or cautionary ways. We conducted a literature search on MEDLINE, PubMed, and PsychArticles to identify relevant articles, which yielded six categories of medical and physiological complications of ED that may be exacerbated by exercise: energy availability, cardiovascular health, electrolyte abnormalities, biomedical function markers, sex hormones, and body composition. We summarize the evidence for these complications for readers and offer an initial set of recommendations for incorporating exercise during ED treatment based on our findings. This review may serve as a resource for members of ED treatment teams to help evaluate more readily and confidently whether exercise is safe for individual patients and when modifications and caution may be warranted. Plain English summary Dysfunctional exercise (DEX) is a symptom of eating disorders (ED) that precedes, maintains and exacerbates ED pathology. Health professionals struggle to clinically address and manage DEX as little information is available about its assessment and safe management. The current review provides a comprehensive summary of the medical and physiological complications of ED that may be exacerbated by exercise and outlines when exercise may be contraindicated or used in a modified or cautionary way. The literature review yielded six categories of complications: energy availability, cardiovascular health, electrolyte abnormalities, biomedical function markers, sex hormones, and body composition. We summarize the evidence for these complications for readers and offer an initial set of recommendations for incorporating exercise during ED treatment based on our findings. This review may serve as a resource for members of ED treatment teams to help evaluate more readily and confidently whether exercise is safe for individual patients and when modifications and caution may be warranted.

• Publisher: BioMed Central,BioMed Central Ltd,BMC
• Subject: Behavioral Science and Psychology / Clinical Psychology / Comorbidity / Complications and side effects / Dysfunctional exercise / Eating disorders / Emergency medicine / Evidence-based medicine / Exercise / Exercise physiology / Health Promotion and Disease Prevention / Hormones, Sex / Incidental activity / Physical activity / Physiological aspects / Psychiatry / Psychology / Review