Muscular capacity, physical exercise and anorexia

Anorexia nervosa, whose name is usually shortened to “anorexia,” is an eating disorder characterized by a fear of gaining weight and an extreme drive to be thin. It is estimated that in Spain alone there are a total of 400,000 people affected by an eating behavior disorder, of which some 300,000 are adolescents. Its adequate treatment and the follow-up of the evolution of the disease are decisive so that they can lead a normal life once the acute problem of the disease has been overcome.

Not everyone affected by an eating behavior disorder uses exercise to expend calories and lose weight, but some patients do. Access to this tool should be made easier for both of them and adjust the dose to their needs, since everyone, when used at the correct exercise dose, benefits from an improvement in body composition. But, how to incorporate physical exercise into the daily routine and the treatment that these patients follow?

In order to clarify the role that muscle capacity and physical exercise play in the recovery of patients, researchers from the Faculty of Physical Activity and Sports Sciences (INEF) at the Polytechnic University of Madrid (UPM) in Spain have conducted a study to examine the relationship between physical activity, sedentary behaviors, physical fitness, and quality of life in a group of adolescents after hospitalization.

Warm-up exercises with weights. (Photo: CDC/Amanda Mills)

“Around 31% of patients engage in unhealthy physical activity in the early stages of the disease as a weight loss strategy, which increases to 80% before hospitalization,” explains Margarita Pérez Ruiz, from INEF at UPM) and co-author of the study.

This is why bed rest and exercise restriction have historically been the strategy of choice in patients with anorexia nervosa. However, this strategy is not without problems. “It has been shown that bed rest has a negative impact on muscle and bone health during hospitalization, while a low mechanical stimulus (exercise) can prevent the decrease in bone turnover in anorexia nervosa”, adds the researcher.

Nevertheless, the incorporation of exercise has been a challenge for health care teams due to the lack of guidelines and sufficient knowledge about safe and effective exercise in patients with anorexia.

Lack of exercise in recovery, more problems than advantages

“Decreased levels of physical activity in patients have been associated with partial recovery of physical fitness, even after restoration of weight or body mass index (BMI). However, health-related components are negatively affected, with reduced cardiorespiratory function, reduced muscular fitness and functional mobility (reduced performance in activities of daily living), and altered body composition, i.e. thicknesses and circumferences of reduced skinfolds on the extremities, low muscle mass and bone mineral density at different stages of treatment. All this persists even after weight and BMI recovery and negatively impacts quality of life”, says Margarita Pérez Ruiz.

After the study, the researchers found that patients with anorexia nervosa who, after inpatient treatment, did not meet the recommended daily physical activity criteria had a deterioration in physical fitness, body composition, and functional mobility, unlike what occurred with those who did engage in physical activity.

“Our work demonstrates that exercise programs aimed at improving fitness through increased muscle fitness after hospitalization may be key to improving quality of life and general health in this population affected by a behavioral disorder. food”, concludes the researcher who underlines the importance of taking these findings into account to implement and integrate the correct dose of exercise in treatment programs.

Researchers from the Psychiatry Service of the Children Jesus University Hospital in Madrid and the Department of Functional Biology of the University of Oviedo, in Spain, have also participated in the work.

The study is titled “Physical Fitness-Not Physical Activity Levels-Influence Quality of Life in Anorexia Nervosa.” And it has been published in the International Journal of Environmental Research and Public Health. (Source: UPM)