Assessment of Physical Activity in Anorexia Nervosa and Treatment Outcome

Alberti, Marta; Galvani, Christel; Ghoch, Marwan El; Capelli, Carlo; Lanza, Massimo; Calugi, Simona; Grave, Riccardo Dalle

doi:10.1249/mss.0b013e31828e8f07

Cited by 40 publications

(60 citation statements)

References 34 publications

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“…They assumed that smoking cigarettes, anxiety and PA have an influence on weight gain, which could not be confirmed by the results. This was also affirmed by Alberti et al (2013), who compared objective and subjective measurement of PA in AN. They could show that accelerometry is sensible and specific in distinguishing between lying, sitting, standing and walking with different velocities, meaning that the acceleration of the device correlates with the energy expenditure and the walking velocity.…”

Section: Validation Of Accelerometrymentioning

confidence: 72%

“…Kostrzewa et al (2013) investigated how high activity levels are influenced by inpatient treatment and found that the PA level normalizes during treatment. Alberti et al (2013), however, showed that the more time spent in light PA at the beginning of the treatment, the less improvement can be seen in ED psychopathology at the end of therapy. Despite this, HLPA leads to long-standing consequences in recovery of leptin serum levels and body composition.…”

Section: Correlations Of Physical Activity Behaviour and Treatmentmentioning

confidence: 92%

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High Levels of Physical Activity in Anorexia Nervosa: A Systematic Review

Gümmer¹,

Giel²,

Schag³

et al. 2015

Euro Eating Disorders Rev

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High level physical activity is a frequent symptom in patients with anorexia nervosa (AN), influencing the development, maintenance, complications, treatment success, relapse rate and severity of the disease. Accelerometry is assumed to be an objective method to assess physical activity (PA) in AN. We aimed to review objectively measured levels of PA in AN and to give an overview for clinical practice and future research. Data were searched in PubMed and PsychINFO until April 2015 following the preferred reporting items for systematic reviews and meta-analyses statement. Twenty studies fulfilled the inclusion criteria. A notable heterogeneity of measurements, outcomes, participants and settings was found. Overall, HLPA is not adressed enough by current evidence. A common valid terminology of HLPA is not available, and accurate criteria of different levels of PA must be defined to create comparability of future studies. Further objective PA assessments are needed to improve treatment outcome and relapse rate.

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Section: Validation Of Accelerometrymentioning

confidence: 72%

Section: Correlations Of Physical Activity Behaviour and Treatmentmentioning

confidence: 92%

High Levels of Physical Activity in Anorexia Nervosa: A Systematic Review

Gümmer¹,

Giel²,

Schag³

et al. 2015

Euro Eating Disorders Rev

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“…It has been associated with increased risk of medical complications (e.g., overuse injuries, bone fractures, and cardiac complications) [67,68,69,70], higher rates of dropout from treatment programmes [71], longer inpatient treatment [72], poorer outcome [62], and quicker relapse [73]. It is also associated with greater severity of eating disorders [74] and general psychopathology, as well as specific personality features such as perfectionism and persistence [64]. It should be noted that many athletes may rely on their perfectionism, a trait associated with setting high goals and working hard to attain them [75], to help them succeed.…”

Section: Resultsmentioning

confidence: 99%

Eating Disorders, Physical Fitness and Sport Performance: A Systematic Review

et al. 2013

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Background: Eating disorders are health problems that are particularly prevalent in adolescents and young adults. They are associated with considerable physical health and psychosocial morbidity, and increased risk of mortality. We set out to conduct a systematic review to determine their effect on physical fitness in the general population and on sport performance in athletes. Methods/Design: A systematic review of the relevant peer-reviewed literature was performed. For inclusion, articles retrieved from PubMed had to be published in English between 1977 and 2013. Wherever possible, methods and reporting adhere to the guidelines outlined in the PRISMA statement. Some additional studies were retrieved from among those cited in the reference lists of included studies and from non-electronic databases. Literature searches, study selection, method and quality appraisal were performed independently by two authors, and data was synthesized using a narrative approach. Results: Of the 1183 articles retrieved, twenty-nine studies met the inclusion criteria and were consequently analysed. The available data indicate that eating disorders have a negative effect on physical fitness and sport performance by causing low energy availability, excessive loss of fat and lean mass, dehydration, and electrolyte disturbance. Discussion: Although the paucity of the available data mean that findings to date should be interpreted with caution, the information collated in this review has several practical implications. First, eating disorders have a negative effect on both physical fitness and sport performance. Second athletics coaches should be targeted for education about the risk factors of eating disorders, as deterioration in sport performance in athletes, particularly if they are underweight or show other signs of an eating disorder, may indicate the need for medical intervention. However, future studies are needed, especially to assess the direct effect of eating disorders on sport performance.

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“…Compulsive exercise poses an obstacle for treatment progress (Solenberger, 2001; Carter et al, 2004; Dalle Grave et al, 2008). Many clinicians have therefore favored the prohibition of exercise during treatment; however, some studies have shown that supervised, moderate physical activity programs may be beneficial (Alberti et al, 2013; Kostrzewa et al, 2013; Sauchelli et al, 2015). The present study shows that compulsive exercise should not be addressed equally in all ED, and interventions incorporating physical activity programs should be adapted to the distinct ED diagnostic subtypes.…”

Section: Discussionmentioning

confidence: 99%

Dimensions of Compulsive Exercise across Eating Disorder Diagnostic Subtypes and the Validation of the Spanish Version of the Compulsive Exercise Test

et al. 2016

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Objectives: Compulsive exercise in eating disorders has been traditionally considered as a behavior that serves the purpose of weight/shape control. More recently, it has been postulated that there may be other factors that drive the compulsive need to exercise. This has led to the development of the Compulsive Exercise Test (CET); a self-reported questionnaire that aims to explore the cognitive-behavioral underpinnings of compulsive exercise from a multi-faceted perspective. The objectives of this study were threefold: (1) to validate the Spanish version of the CET; (2) to compare eating disorder diagnostic subtypes and a healthy control group in terms of the factors that drive compulsive exercise as defined by the CET; (3) to explore how the dimensions evaluated in the CET are associated with eating disorder symptoms and general psychopathology.Methods: The CET was administered to a total of 157 patients with an eating disorder [40 anorexia nervosa, 56 bulimia nervosa (BN), and 61 eating disorder not-otherwise-specified (EDNOS)] and 128 healthy weight/eating controls. Patients were assessed via a semi-structured interview to reach a DSM-IV-TR diagnosis. Additionally, all participants completed the Symptom Checklist-90-Revised (SCL-90R) and the Eating Disorders Inventory-2 (EDI-2).Results: Confirmatory factor analysis demonstrated adequate goodness-of-fit to the original five-factor model of the CET. BN and EDNOS patients scored higher in the avoidance and rule-driven behavior, weight control, and total CET scales in comparison to the healthy controls, and higher across all scales apart from the exercise rigidity scale compared to the anorexia nervosa patients. Mean scores of the anorexia nervosa patients did not differ to those of the control participants, except for the mood improvement scale where the anorexia nervosa patients obtained a lower mean score. Mean scores between the BN and EDNOS patients were equivalent. The CET scales avoidance and rule-driven behavior, weight of control and total CET scores were positively correlated with the clinical assessment measures of the SCL-90R and EDI-2.Conclusion: Compulsive exercise is a multidimensional construct and the factors driving compulsive exercise differ according to the eating disorder diagnostic subtype. This should be taken into account when addressing compulsive exercise during the treatment of eating disorders.

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Assessment of Physical Activity in Anorexia Nervosa and Treatment Outcome

Abstract: PA in patients with anorexia nervosa is underestimated by subjective assessment when compared with objective measurement. Only time spent in light PA, assessed objectively with AH, showed a negative association with improvement in eating disorder psychopathology.

Cited by 40 publications

References 34 publications

High Levels of Physical Activity in Anorexia Nervosa: A Systematic Review

High Levels of Physical Activity in Anorexia Nervosa: A Systematic Review

Eating Disorders, Physical Fitness and Sport Performance: A Systematic Review

Dimensions of Compulsive Exercise across Eating Disorder Diagnostic Subtypes and the Validation of the Spanish Version of the Compulsive Exercise Test

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