24 May Exercise to treat an eating disorder?

Accredited Exercise Physiologist, Alanah Dobinson, tackles the tricky topic of exercise and restrictive forms of eating issues for Exercise Right.

Eating disorders are not only a condition of the psyche, but also of the body. Why, then, does current practice neglect physical movement as therapy?

Eating Disorders: The stats

• 1 million Aussies have a reported eating disorder (key word: reported) (NEDC, 2012)
• Mortality rate for those with anorexia nervosa (AN) is 10-12 times higher than the general population (Birmingham et al, 2005)
• Cost of AN is second only to cardiac artery bypass surgery in Australia’s private hospital sector (NEDC, 2012)
• Most complications are reversible (Westmoreland et al, 2016)
• Eating issues create some of the most intense physical, mental and emotional conditions to recover from

•  Categories:
  • Anorexia Nervosa (AN)
  • Bulimia Nervosa (BN)
  • Restricting Subtypes (RS)
  • Binge Eating Disorder (BED)
  • Eating Disorders Not Otherwise Specified (EDNOS)

The fractured model of care

It wasn’t long ago that we prescribed three months of bed rest to those who’d had a heart attack, now we get them moving as soon as we can.

Bed rest and social isolation were prescribed for centuries to those with eating issues. What did this achieve? Not only did the patients’ bodies deteriorate, mental health suffered and comorbid disease skyrocketed.

In a population where the disease behaviour stems for a psychological need for control, they also lost their sense of control. Not only was food being force-fed into these unwilling patients’ mouths, they were also isolated and banned from movement. Due to this restrictive environment noncompliance to therapy is a boringly predictable outcome for these clients.

Enter: Exercise Physiology

Eating disorders are multifaceted. Why, then, isn’t the therapeutic approach?

Sure, focussing on the mind’s psychology, prescribing medication and food nutrition therapy are necessary. The link between healthy movement and healthy mind is heavily researched and acknowledged. Let’s try clinically safe, effective and fun movement therapy. Enter: Exercise Physiology.

How does exercise affect those living with an eating disorder?

Increases:

• Associations with exercise that don’t revolve around punishment or weight loss 
• Permission to eat and relax
• Community involvement and socialising
• Positive connectedness to the body
• Self-efficacy
• Clear thinking, memory and concentration 
• Education & understanding about safe movement 
• Feasibility & acceptability of interventions; program compliance

Decreases:

• Covert and secretive activity
• Depression & Anxiety 
• Risk of progression of disease 
• Exercising whilst injured, dehydrated (or sedentary behaviour)
• Powerless feelings of restricting exercise
• Relapse
• Isolation
• Food preoccupation

Let’s get started

It is important to see an Accredited Exercise Physiologist  (AEP) before engaging in exercise. The AEP will understand your condition and work with the other allied health professionals (AHPs) in your team to form the most appropriate treatment plan for you as an individual.

Sessions can range from education and information (if you are not ready to mentally or physically engage in movement) to many forms of clinically safe exercises.

Click to find out more about Exercise and Mental Health.

Alanah Dobinson is an Accredited Exercise Physiologist and the Mental Health Programs Coordinator at Iridium Health, South Brisbane. Alanah brings immense passion to movement therapy within the mental health sector, where she works with a large number of organisations including Headspace.