Guiding principles to inform future exercise protocols for eating disorder treatment

Authored by: Danika A. Quesnel, MSc, CSEP-CPT, Brian Cook, PhD Cristina M. Caperchione, PhD

Practices such as yoga asana, which involves mindful connection to breathing to promote relaxation were suggested.
Practices such as yoga asana, which involves mindful connection to breathing to promote relaxation were suggested.
  Articles, Clinical Articles, Eating Disorders, Movement, Resources, Blog

Article Overview

As awareness and concerns over access to mental health resources have grown over the past decade, so, too has the evidence supporting the incorporation of exercise; engaging in physical activity has been shown to elicit clinical improvement on par with medication for mild to moderate anxiety and depressive disorders. Missing from the conversation until relatively recently is the application of exercise in the treatment of eating disorders (ED).


While Alsana embraces movement as an invaluable part of eating disorder care, this summary is just an overview of one collaborative study’s findings and does not necessarily reflect Alsana’s philosophy or approach in the application of movement and exercise during and after eating disorder treatment; the study’s findings reflect the viewpoints and experience of its participants only.

Movement is a key component of Alsana's approach to eating disorder treatment
Movement is a key component of Alsana's approach to eating disorder treatment

The Purpose

The purpose of the study was to identify ED-specific guidelines for the application of exercise in terms of Frequency, Intensity, Time, and Type.


The Approach

The study involved a total of 12 carefully vetted participants from North America and Europe who were identified through purposeful recruitment over six months’ time (ED professionals, 75% female, with a mean age of 46.5 y).




Frequency of Exercise

The Frequency of ED client exercise depends on factors including:

  • Individual needs of the client
  • Type of exercise
  • The goal of exercise (Example: building muscle vs. improving flexibility)

Intensity of Exercise

The Intensity of exercise varies per individual as well, again, depending in part on individual health needs and goals. For some clients, intense movement practices may be needed in order to rebuild muscle mass. This in no way negates the importance of examining motivation for exercise but is a relatively new part of the conversation around how and if exercise should be introduced in the treatment of ED.

Time (Duration) of Exercise

Starting an exercise protocol at 20-30 minutes was often suggested by participants. They also suggested that, regardless of modality, frequency and duration of sessions should follow a graded protocol.

Type of Exercise

Practices which involve “mindful connection to breathing” to promote relaxation were­­ suggested, including, for example:

  • Exercise bands
  • Group yoga classes (in a climate-controlled environment)
  • Whole-body stretching

The spectrum of movement options, addressing different client needs, also included (but is not limited to) weight-bearing activities (important for maintaining and improving bone health) and bodyweight exercises such as Pilates or use of free weights.

It is important to note that Type variation is important not only in terms of physical functionality or mood regulations, but also to retrain the brain to be receptive to different kinds of, and motivations for exercise.


Other Considerations for Exercise

  • Client cardiovascular health
  • Attitudes towards exercise
  • ED-informed movement instructors


What does it mean?

The findings from this study expand the role of exercise professionals in clinical mental health settings.

At Alsana, we believe a holistic, client-centered approach to full recovery includes an intentional focus on rebuilding and healing clients’ relationships with exercise.


Read more about the study here. >>>

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