Physical activity and exercise dependence during inpatient treatment of longstanding eating disorders: An exploratory study of excessive and non‐excessive exercisers

Bratland‐Sanda, Solfrid; Sundgot‐Borgen, Jorunn; Rø, Øyvind; Rosenvinge, Jan H.; Hoffart, Asle; Martinsen, Egil W.

doi:10.1002/eat.20769

Cited by 102 publications

(118 citation statements)

References 34 publications

(38 reference statements)

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“…This is an important observation given the fact that previous studies using the ABA model have relied almost completely on the sedative actions of agents such as the antipsychotic drug, olanzapine to sever the nexus between weight loss and excessive exercise (Hillebrand et al, 2005b). This nexus is also an important focal point for therapies in the human condition (Bratland-Sanda et al, 2010). The combination of 2.0 mg/kg/day THC and a HFD produced a significantly greater attenuation of weight loss that was different than would be attributed to the attenuation of weight loss observed with vehicle-treated high fat and THC-treated chow fed animals ( Figure 4).…”

Section: Discussionmentioning

confidence: 91%

The Cannabinoid Receptor Agonist THC Attenuates Weight Loss in a Rodent Model of Activity-Based Anorexia

Verty

Evetts

Crouch

et al. 2011

Neuropsychopharmacol

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Anorexia nervosa (AN) is characterized by anhedonia whereby patients experience little pleasure or reward in many aspects of their lives. Reward pathways and the endocannabionid system have been implicated in the mediation of food intake. The potential to exploit these systems to reverse weight loss is investigated in a rodent model of activity-based anorexia (ABA). The effect of subchronic (6 days) Δ(9)-tetrahydrocannabinol (THC) treatment (0.1, 0.5, or 2.0 mg/kg/day) was assessed on chow and high-fat diet (HFD) intake, body weight, running wheel activity (RWA) as well as thermogenesis in brown adipose tissue (BAT) and lipid metabolism in white adipose tissue (WAT). Limited time availability of food and continuous access to running wheels led to anorexia and significantly reduced body weight. THC treatment (0.5 and 2.0 mg/kg/day) transiently stimulated chow intake with a moderate effect on RWA. THC (2.0 mg/kg/day) significantly reduced body weight loss and shifted markers of thermogenesis in BAT and lipid metabolism in WAT in directions consistent with reduced energy expenditure and lipolysis. THC (2.0 mg/kg/day) combined with HFD, produced a transient increase in food intake, reduction in RWA, attenuation of body weight loss, and changes in markers of thermogensis in BAT and lipolysis in the WAT. These changes were significantly greater than those seen in vehicle (HFD), vehicle (chow), and THC (chow)-treated animals. These data show for the first time the effectiveness of the endocannabinoid system in attenuating the weight loss associated with the development of ABA via a mechanism involving reduced energy expenditure.

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Section: Discussionmentioning

confidence: 91%

The Cannabinoid Receptor Agonist THC Attenuates Weight Loss in a Rodent Model of Activity-Based Anorexia

Verty

Evetts

Crouch

et al. 2011

Neuropsychopharmacol

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“…For example, a recent prospective study has found reductions in exercise pathology scores (e.g. exercise dependence) are correlated with reduction in ED psychopathology (6). …”

Section: Discussionmentioning

confidence: 99%

Exercise in Eating Disorders Treatment

Cook

Wonderlich

Mitchell

et al. 2016

Medicine &Amp; Science in Sports &Amp; Exercise

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Introduction Although exercise is an effective intervention for many psychological health issues, it has often been overlooked as a potential adjunct to ED treatment. Thus, our objective was to summarize the literature by synthesizing themes identified in clinical studies and explicit guidelines or recommendations for the use or management of exercise in ED interventions into a proposed set of guidelines for the use of exercise in ED treatment. Method A literature search in exercise science, health psychology, and the ED literatures was conducted. The focus was to obtain articles that reported on therapeutic effects and/or guidelines for the therapeutic use of exercise in individuals with ED. Results Our review identified 11 core themes describing techniques that have been successful in using exercise therapeutically in ED treatment. These 11 guidelines are: employ a team of relevant experts, monitor medical status, screen for exercise related psychopathology, create a written contract of how therapeutic exercise will be used, include a psych-educational component, focus on positive reinforcement, create a graded exercise program, begin with mild intensity exercise, tailor the mode of exercise to the needs of the individual, include a nutritional component, and debrief after exercise sessions. Conclusion Our review identifies specific guidelines that may enhance ED treatment outcomes. It is the first to summarize divergent literatures and synthesizes previous successes that may guide the use of therapeutic exercise in some, but not all ED patients. This review provides a practical set of guidelines for the clinical management and therapeutic use of exercise in ED treatment by focusing on empowering individuals with exercise as a tool for healthy living.

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“…We assumed that the AN-R observed in the S group represented the obsessive pole of this spectrum, whereas AN of the binge–purge type and BN represented the impulsive pole [29,30]. Excessive exercise, which was more frequently observed in the S group, has been considered to be a compulsive behavior and indicates greater eating disorder severity [31-35]. These findings suggest that repeated shoplifting in patients with eating disorders is an OC trait.…”

Section: Discussionmentioning

confidence: 99%

Eating disorders among patients incarcerated only for repeated shoplifting: a retrospective quasi-case-control study in a medical prison in Japan

et al. 2014

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BackgroundShoplifting is a serious problem among patients with eating disorders. For more than a decade, we have treated many patients with eating disorders incarcerated in Hachioji Medical Prison only for repeated shoplifting.MethodsWe analyzed the prison records and medical records of female psychiatric patients transferred to Hachioji Medical Prison between 2002 and 2011. Based on the offense listed at the time of sentencing, we extracted a shoplifting group and a drug-offense group from among all patients with eating disorders. One patient from the former group who had used substances and two from the latter group who had never shoplifted were excluded from the study. The groups had 41 and 14 patients, respectively. A control group comprised patients with other mental disorders (n = 34). We compared eating disorder histories and subtypes, weight changes, comorbidities, life histories, past behavioral problems, and clinical behavioral problems among the three groups.ResultsThe shoplifting group exhibited less impulsive behavior, substance abuse, antisocial features, borderline personality disorder, and past bulimia than did the drug-offense and control groups. The shoplifting group had higher educational achievement and steadier employment; however, their eating disorder histories and interpersonal dysfunction were more severe, and they had a higher psychiatric treatment dropout rate. There were also significant relationships with low body weight, anorexia nervosa-restricting type, obsessive–compulsive behaviors, and obsessive–compulsive personality disorder in the shoplifting group. During the clinical course, food refusal, excessive exercise, food hoarding, and falsification of dietary intake amounts were more frequently observed in the shoplifting group. Conversely, drug requests and occurrences of self-harm were less frequent in the shoplifting group than in the drug-offense group.ConclusionsAlthough these results may be associated with specific characteristics of patients with eating disorders in the medical prison setting, we concluded that the repeated shoplifting by these patients is unrelated to antisocial or impulsive characteristics but is deeply rooted in these patients’ severe and undertreated eating disorder psychopathology. Strong supportive treatment should be considered for patients with eating disorders who develop shoplifting behaviors. Further research is required to elucidate the mechanisms responsible for the relationship between shoplifting and eating disorders.

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Physical activity and exercise dependence during inpatient treatment of longstanding eating disorders: An exploratory study of excessive and non‐excessive exercisers

Cited by 102 publications

References 34 publications

The Cannabinoid Receptor Agonist THC Attenuates Weight Loss in a Rodent Model of Activity-Based Anorexia

The Cannabinoid Receptor Agonist THC Attenuates Weight Loss in a Rodent Model of Activity-Based Anorexia

Exercise in Eating Disorders Treatment

Eating disorders among patients incarcerated only for repeated shoplifting: a retrospective quasi-case-control study in a medical prison in Japan

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