Effectiveness of exercise‐based interventions in patients with anorexia nervosa: A systematic review

• Published in: European Eating Disorders Review 2021-01, Vol.29 (1), p.3-19
• Main Authors: Quiles Marcos, Yolanda, León Zarceño, Eva, López López, José Antonio
• Format: Article
• Language: English
• Subjects: Anorexia; Exercise; physical activity; Systematic review
• ISSN: 1072-4133; 1099-0968
• DOI: 10.1002/erv.2789

Objective This study aimed to conduct a systematic review of research that has evaluated the outcomes of exercise‐based interventions in anorexia nervosa (AN) patients. Method We searched for studies in the MEDLINE, Embase, Web of Science, PsycInfo, Scopus and SPORTDiscus databases. We followed Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines throughout the selection process, and used Cochrane tools to assess the risk of bias in the primary studies. In cases where sufficient information was available, outcomes were pooled using meta‐analytic techniques. Results Ten studies were included in the review. Results showed similar changes in body mass index in both experimental and control conditions (difference in mean changes of −0.53, 95% CI −1.52 to 0.46). We found no differences in depression or anxiety as a result of implementing exercise programmes. Studies using resistance or strength exercise programmes reported an increase in lower and upper body strength and in skeletal muscle mass in the intervention groups. Conclusion The incorporation of a supervised physical exercise programme to the usual treatment may be appropriate for AN patients. Exercise interventions should only be performed when they are safe for AN patients and should be focused on resistance/strength or flexibility exercises. The results from this systematic review should be interpreted with caution because the studies reviewed showed serious methodological problems. HIGHLIGHTS This systematic review highlights the paucity of data to make decisions about the relevance of structured and supervised exercise as a treatment in patients with anorexia nervosa (AN) Supervised physical exercise interventions were not associated with weight loss in patients with AN Physical exercise interventions focused on resistance/strength or flexibility have no additional effect on anthropometry, but they might improve vital signs, muscle function and strength, and eating disorder symptomatology Physical exercise programmes have not shown significant effects on psychological variables such as anxiety and depression