Table 2 Summary of exercise in inpatient treatment of eating disorder patients: a chain of approaches from admission to discharge, and from rest to regular exercise groups
Assessment at admission | Motives and maintenance factors (e.g., weight regulation, improved appearance, avoidance of difficult emotions) Consequences if exercise is restricted or stopped Performance of exercise (e.g., rigid or flexible, joyful, social, or done alone) Awareness of bodily signals (e.g., recognize when hungry or tired) Previous exercise experience (e.g., type, frequency, intensity, duration) |
Psychoeducation | Relevant topics Healthy exercise Anatomy and bodily functions Rest and relaxation Balance between exercise, rest, and nutrition Exercise as a symptom of an eating disorder Negative and compulsive attitudes and thoughts |
Practical supervision and body-oriented work | Assistance to recognize and develop healthy coping strategies in daily activities (e.g., rest, outdoor walks) Relaxation exercises Enhancement of body awareness (e.g., bodily signals, mindfulness) |
Healthy exercise | Facilitate a social and noncompetitive atmosphere for enjoyable physical activities Outdoor activities (e.g., mountain hiking, climbing, horse riding) Regular exercise groups |
Exercise groups | Based on basic training principles (variation, adjusted progression, enhancing cardiovascular endurance, muscular strength, and endurance) Individual supervision Good restitution |
Practical considerations | All patients: The symptoms, capacity, and needs of the patients during treatment Underweight patients: Loss of muscular tissue, low bone density, and other somatic symptoms Planned weight gain must continue |
Personnel | Educated personnel in both eating disorder and exercise/body-oriented therapy |