Positive and negative aspects of exercise in the treatment of eating disorders and substance use disorders

Abstract

Engaging in regular physical activity is a fundamental part of good physical health and increasingly appreciated as essential to psychological well-being and improved mental health. Strong evidence supports that engaging in exercise and physical activity can transiently improve mood and decrease anxiety, reduce mortality rates particularly in men, and improve response to treatment for nicotine addiction. While less understood, physical fitness and exercise can positively impact on treatment response for patients with eating disorders and substance use disorders. Of interest is that problematic exercise can be in and of itself a primary behavioral addiction or associated with other problems such as eating disorders or anxiety disorders and secondary to concerns of body image, self-esteem, health concerns, or social function. Treatment strategies for problematic exercise include addiction and compulsive/anxiety models that are not mutually exclusive and can help clinicians work effectively with patients. This chapter will briefly review the literature underscoring the positive impact of physical activity and fitness on medical and mental health, identify the characteristics of problematic exercise in the eating disorder population, discuss treatment approaches for problematic exercise, and finally review the potential positive effects of physical activity in the treatment of patients with eating disorders and/or substance use disorders.