Resistance training is an underused and promising tool in eating disorder recovery: a narrative review

Individuals with eating disorders may experience reduced bone mineral density and muscle mass, lower quality of life, and debilitating psychopathology. Abstinence from exercise has historically been recommended in the treatment of eating disorders. However, evidence shows that well-planned, supervised exercise can be safe and beneficial. Resistance training is an exercise modality of particular interest because of its ability to protect bone and muscle mass, in addition to its mental health and quality of life benefits. The purpose of this narrative review is to examine the use of resistance training in the treatment of eating disorders to determine whether its incorporation in treatment programs should be recommended.

A search of the literature was conducted via PubMed, Web of Science, ScienceDirect, and Sage Journal. Articles published before the final database search (March 22nd, 2025) were considered.

Studies must examine how the use of resistance training affects people with anorexia nervosa, bulimia nervosa, or binge eating disorder, and must be published in English. Both quantitative and qualitative literature were included.

A total of 17 studies were examined. Quantitative research revealed significant improvements in body composition, strength, and quality of life when resistance training was included in treatment. The available evidence suggests that higher loading is well-tolerated and is more effective than low loading at improving body composition. Qualitative research demonstrated participants' positive attitudes toward the use of resistance training during treatment. The participants reported improved relationships with exercise, citing the emphasis on building strength as an empowering motivator that deemphasizes weight loss.

In combination with a multidisciplinary team including a dietitian, psychologist, and medical provider, resistance training has the potential to play an important role in improving psychopathology, quality of life, and body composition in patients with eating disorders. More research is needed in this area before its inclusion in treatment can be confidently recommended. Plain english summary People with eating disorders experience reduced bone mineral density muscle mass, and report low quality of life. Although abstinence from exercise has historically been recommended in the treatment of eating disorders, its intentional application may confer meaningful benefits to both physical and mental health. Resistance training is a modality that shows promise for improving many eating disorder symptoms, including protecting and increasing bone and muscle health and improving quality of life.