Compulsive exercise treatment interventions among individuals with eating disorders: A systematic review


Compulsive exercise is often experienced among individuals with eating disorders. When compulsive exercise is left unaddressed, it can lead to longer treatment, shorter periods between relapse, and worse health outcomes. If addressed appropriately in treatment, individuals with compulsive exercise can develop a healthy relationship with exercise and learn to experience the positive benefits of engaging in physical activity over the lifespan. To date, there are no standardized guidelines or consensus on best approaches for treating compulsive exercise. Therefore, the purpose of this review was to examine the treatment effects of compulsive exercise interventions among individuals with eating disorders. A systematic review of seven databases was conducted, following the PRISMA guidelines. Eleven studies met inclusion criteria and were included for review. Across all studies, improvements in compulsive exercise was noted, as well as a positive impact on reducing eating psychopathology. The programs were 4 to 16 weeks long, and included two to five sessions a week dedicated to addressing compulsive exercise. All treatment programs focused on exercise psychoeducation to address attitudes, beliefs, and thoughts around exercise, and to challenge motives for engaging in exercise. The majority of programs also incorporated exercise sessions during treatment to expose the individuals to a healthy model of exercise and process emotions with health professionals. The findings from this review highlight the positive impact of treating compulsive exercise, and suggest it should incorporated into standard eating disorder treatment.