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Managing Exercise in Eating Disorder Treatment and Adapting Treatment for Athletes
Sasha Gorrell1, Catherine Drury1, Katherine Schaumberg2
1Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
The Psychiatric Clinics of North America
|February 18, 2026
Summary
Compulsive exercise is a common eating disorder (ED) symptom lacking clear treatment guidelines. This review synthesizes evidence and offers recommendations for screening, treatment, and return to play for athletes with EDs.
Area of Science:
- Clinical Psychology
- Sports Medicine
- Eating Disorder Treatment
Background:
- Compulsive exercise is a frequent symptom in eating disorders (EDs).
- Lack of consensus exists on managing exercise in ED treatment, particularly for athletes.
- This can lead to prolonged illness and hinder recovery.
Purpose of the Study:
- To review current evidence on exercise management in ED treatment.
- To provide recommendations for screening, treatment, and return to play protocols.
- To identify future research directions for compulsive exercise in ED populations and athletes.
Main Methods:
- Systematic literature review of clinical evidence.
- Synthesis of current practices in ED treatment regarding exercise.
- Development of evidence-based recommendations.
Main Results:
- Current evidence on exercise management in EDs is limited.
- Best practices for screening, treatment, and return to play are not well-established.
- Specific challenges exist when treating athletes with EDs and compulsive exercise.
Conclusions:
- There is a critical need for evidence-based guidelines for managing compulsive exercise in ED treatment.
- Recommendations are provided for clinical practice and future research.
- Addressing exercise is crucial for improving outcomes in individuals with EDs, especially athletes.
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