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

Abstract

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.

Keywords

• Eating disorders
• Dysfunctional exercise
• Physical activity
• Exercise
• Incidental activity
• Exercise physiology