Exercise and Eating Disorders

The term ‘eating disorders’ (EDs) covers a range of serious mental health conditions that involve a severe disruption to someone’s eating behaviors. EDs are estimated to affect around 4% of Australians. They are most often diagnosed in female adolescents and young adults, but EDs can affect anyone.

People with an ED are often preoccupied with food and body weight, size, or shape. They may also have an unhealthy relationship with exercise, which is why professional support is often needed to exercise safely (more about this below).

There are several types of ED, including:

  • Anorexia nervosa – which involves a severe restriction or avoidance of food.
  • Bulimia nervosa – this involves eating unusually large amounts of food in a short period (binge eating), followed by behaviors such as forced vomiting, excessive exercise, or fasting,
  • Binge eating disorder – this involves binge eating without the compensatory behaviours that follow in bulimia nervosa.
  • Avoidant/restrictive food intake disorder (ARFID) – an aversion to food or restriction of how much and which foods are eaten.
  • Other specified feeding and eating disorder (OSFED) – people with this condition have symptoms of another eating disorder that don’t meet the full criteria to be diagnosed with that disorder.
  • Unspecified feeding or eating disorder (UFED) – this involves behaviours that cause significant distress or functional difficulties which don’t meet the criteria for other disorders.
  • Pica – which involves eating non-food substances (such as chalk) or those with no nutritional value (such as ice) regularly.


Exercise is an effective form of therapy for many mental health conditions, but its role in managing EDs has often been neglected. This is partly because some ED symptoms have been linked to unhelpful exercise behaviours, such as excessive exercise to ‘compensate’ for binge eating. More research is needed to clarify this relationship.

Furthermore, a recent study showed the lack of therapeutic exercise in ED treatment programs reflects a limited understanding of the role of Accredited Exercise Physiologists (AEPs). The authors suggest AEPs can play a vital role in treating people with EDs.


Studies have also suggested that when an individual’s nutritional needs are met, well-designed exercise programs may improve ED treatment outcomes.

For example, a 2014 review of 8 studies found aerobic and resistance training led to significantly increased muscle strength, body mass index and body fat percentage in people with anorexia nervosa. Additionally, aerobic exercise, yoga, and basic body awareness therapy (along with massage) led to lower scores on tests of disordered eating and depressive symptoms in people with anorexia and bulimia nervosa.

A 2016 systematic review described 11 guidelines for using exercise as part of ED treatment. These include tailoring programs to each person’s needs and using a team of relevant experts to develop programs and monitor progress with exercise.

A 2019 meta-review analysed 27 studies exploring the use of ‘exercise as medicine’ for people with mental health conditions. The researchers found exercise had positive mental health benefits for people with anorexia nervosa, bulimia nervosa, and binge eating disorder.

Similarly, the Safe Exercise at Every Stage (SEES) Guidelines note safe exercise can help with managing ED symptoms.


The lead author of the 2016 review suggests the following:

  • Cardiorespiratory training – not exceeding the American College of Sports Medicine’s recommendations of 150 minutes per week of moderate-intensity exercise.
  • Resistance training – performed two to three days a week and starting at a light intensity, with 48 hours rest between sessions.
  • Flexibility training – performed two to three days a week to improve range of movement.

However, given the complex relationship between exercise and eating disorders, there’s no one-size-fits-all approach. It’s vital your exercise program is suited to your needs and goals.

The SEES Guidelines recommend exercise programs should be graded, tailored to each person’s needs, and delivered in conjunction with psychological and nutrition therapies.


People with eating disorders can have a range of issues that affect their ability to exercise. For example, they may have conditions of the heart, gut, muscles, nervous and immune systems, along with electrolyte and hormone imbalances.

People with EDs are also more likely to experience other mental health difficulties, including anxiety, depression, substance use disorders, self-harm behaviours, and suicidal thinking/behaviours.

Professional support can help to ensure exercise is safe and effective, especially when other physical or mental health concerns are present. As university-qualified health professionals, AEPs have the training and knowledge to design exercise programs for people with a wide range of health conditions. Some AEPs have a special interest in supporting people with mental health conditions such as EDs.

An AEP understands the factors that could impact your ability to exercise. They will create a program tailored to your needs, goals, and preferences, and provide support for exercise to become an effective part of managing your condition.


Click here to find an exercise physiologist near you.

Written by Amanda Semaan and Kara Foscholo. Amanda and Kara are Accredited Exercise Physiologists and Co-Directors of Active Ability, whose mission is to support people with disability to achieve optimal independence, health, and quality of life.