Is supervised exercise training safe in patients with anorexia nervosa? A meta-analysis.

Area of Science:

• Clinical Psychology
• Sports Medicine
• Nutritional Psychiatry

Background:

• Anorexia nervosa (AN) is frequently preceded by excessive physical activity.
• Exercise is typically excluded from AN treatment due to this association.
• The role of supervised exercise in AN management requires investigation.

Purpose of the Study:

• To systematically review the effects of supervised exercise training in patients with anorexia nervosa.
• To assess the safety and efficacy of incorporating exercise into AN treatment protocols.

Main Methods:

• A systematic review was conducted using five databases (inception to 2011) with keywords 'anorexia' and 'exercise'.
• PRISMA guidelines were followed, including randomized controlled trials and quasi-randomized studies, excluding case reports.
• Data extraction and quality assessment (PEDro and Downs and Black scales) were performed independently by two reviewers.

Main Results:

• Supervised exercise showed no significant effect on anthropometric measurements in pooled RCTs and quasi-RCTs.
• Single-group studies indicated significant improvements in weight and body fat with exercise.
• Cardiovascular fitness improved, distorted feelings about food and exercise decreased, despite no significant change on the Short Form-36.

Conclusions:

• Supervised exercise training appears safe for anorexia nervosa patients, with no adverse anthropometric effects.
• Improvements in cardiovascular fitness and strength were observed.
• Limitations include heterogeneity in exercise programs, small sample sizes, and potential publication bias.