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Open AccessReview

Physical Activity in Eating Disorders: A Systematic Review

INSERM U1178, Maison de Solenn, 97 Boulevard De Port Royal, 75014 Paris, France
Université Paris-Sud and Université Paris Descartes, Ecole Doctorale des 3C (Cerveau, Cognition, Comportement), UMR-S0669, 75006 Paris, France
Psychiatry Unit, Institut Mutualiste Montsouris 42, Boulevard Jourdan, 75014 Paris, France
Nutrition Program, Department of Natural Sciences, Lebanese American University, Beirut 1102, Lebanon
Laboratoire EA 29 31, LINP2-APSA, et Laboratoire EA 4430 CLIPSYD Université Paris Nanterre UFR-STAPS, 200, Avenue de la République, 92001 Nanterre CEDEX, France
INCIA UMR-5287 CNRS, Université de Bordeaux, 33076 Bordeaux, France
Sciences Cognitives et Sciences Affectives, Université de Lille, CNRS, UMR 9193—SCALab, 59045 Lille, France
Département de Psychiatrie, Hôpital Saint Vincent de Paul, GHICL, F-59000 Lille, France
Institute of Psychiatry and Neurosciences of Paris, Unité Mixte de Recherche en Santé (UMRS) 1266 Institut National de la Santé et de la Recherche Médicale (INSERM), University Paris Descartes, 75014 Paris, France
Department of Biology, University of Lille, 59000 Lille, France
Author to whom correspondence should be addressed.
Rizk Melissa and Mattar Lama contributed equally to the writing of this article.
Nutrients 2020, 12(1), 183;
Received: 27 November 2019 / Revised: 29 December 2019 / Accepted: 2 January 2020 / Published: 9 January 2020
(This article belongs to the Special Issue Nutrition and Fitness: Mental Health)
Abnormally high levels of physical activity have been documented throughout the literature in patients with eating disorders (ED), especially those diagnosed with anorexia nervosa (AN). Yet no clear definition, conceptualization, or treatment of the problematic use of physical activity (PPA) in ED patients exists. The aim of this review is to propose a new classification of PPA, report the prevalence, triggers, predictors, maintainers and other related factors of PPA in ED patients, in addition to proposing a comprehensive model of the development of PPA in AN. A total of 47 articles, retrieved from Medline and Web of Science, met the inclusion criteria and were included in the analysis. As a result, the new approach of PPA was divided into two groups (group 1 and group 2) according to the dimension (quantitative vs qualitative approach) of physical activity that was evaluated. The prevalence of PPA in ED was reported in 20 out of 47 studies, the comparison of PPA between ED versus controls in 21 articles, and the links between PPA and psychological factors in ED in 26 articles, including depression (16/26), anxiety (13/26), obsessive–compulsiveness (9/26), self-esteem (4/26), addictiveness (1/26), regulation and verbal expression of emotions (1/26) and anhedonia (1/26). The links between PPA and ED symptomatology, PPA and weight, body mass index (BMI) and body composition in ED, PPA and age, onset, illness duration and lifetime activity status in ED, PPA and ED treatment outcome were reported in 18, 15, 7, 5 articles, respectively. All of the factors have been systematically clustered into group 1 and group 2. Results focused more on AN rather than BN due to the limited studies on the latter. Additionally, a model for the development of PPA in AN patients was proposed, encompassing five periods evolving into three clinical stages. Thus, two very opposite components of PPA in AN were suggested: voluntarily PPA increased in AN was viewed as a conscious strategy to maximize weight loss, while involuntarily PPA increased proportionally with weight-loss, indicating that exercise might be under the control of a subconscious biological drive and involuntary cognition. View Full-Text
Keywords: review; eating disorders; physical activity; problematic use of physical activity review; eating disorders; physical activity; problematic use of physical activity
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MDPI and ACS Style

Melissa, R.; Lama, M.; Laurence, K.; Sylvie, B.; Jeanne, D.; Odile, V.; Nathalie, G. Physical Activity in Eating Disorders: A Systematic Review. Nutrients 2020, 12, 183.

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