Scientific Programme
Sports and Exercise Medicine and Health
IS-MH08 - Moving Forward! Advancements in Physical Activity, Exercise and Eating Disorders
Date: 03.07.2024, Time: 13:15 - 14:30, Lecture room: Lomond Auditorium
Description
Historically, eating disorder (ED) treatment programs have directed patients to abstain from movement. However, this idea has continued to be challenged by clinicians and researchers over the last 20 years. Despite advancements, the field of EDs has been hesitant to implement movement protocols into treatment. Clinicians worry as there is a lack of knowledge on how to adequately manage exercise as an ED symptom. Fueling this hesitation is a myriad of myths about movement in EDs that have permeated the field. The following symposium will aim to debunk these myths to help researchers, clinicians and exercise professionals alike develop a clearer understanding of the role of movement on both the general and athletic population with EDs. First, we will focus on the advancements in our understanding of the biophysiological mechanisms and body systems impacted during an ED, and how movement can be detrimental or beneficial. We will move on to explain updated psychological conceptualizations of difficulties with movement for individuals with EDs. Finally, we will offer guidelines for how adapted and supervised movement can be used as a complementary part of treatment and in the recovery process of persons with EDs. The symposium will provide research evidence to dispel myths around movement and EDs, and thus help clinicians, researchers, exercise professionals and families gain a better understanding of the role of movement in EDs and how to address it with patients.
Chair(s)
Bratland-Sanda Solfrid
University of South-Eastern Norway, Department of sport, physical education and outdoor studies
Norway
Gian Mario Migliaccio
San Raffaele Open University, Department Human Sciences and Promotion of the Quality of Life
Italy
Speaker A
Maria Fernandez del Valle
Universidad de Oviedo, Biología Funcional
Spain
Read CVECSS Glasgow 2024: IS-MH08
Body Systems and Biophysiological Advancements in EDs
Eating disorders impact all systems of the body. Among them, the nervous system is the most studied in EDs with neurobiology being one main area receiving extensive attention. Historically, brain function has been examined through cerebrospinal fluid samples. However, over the past decades, in vivo brain imaging has made possible the study of the structure, composition, activity, and biological function of the brain and food-related behaviors. Beyond neurobiology, scattered research has exposed significant biophysiological alterations at multiple levels in EDs like altered body composition, dysbiosis of the gut microbiota, epigenetic changes, or impaired inflammatory and metabolic responses. An individual who engages in maladaptive movement during an ED exacerbates dysfunction of all body systems and, as a consequence, undermines treatment efforts by reducing the probability of full recovery. Adapted exercise unfolds as a crucial tool to modulate several of these alterations, however, clinical teams lack of resources to help them manage maladaptive movement (a critical ED symptom). In addition of having a better understanding of these alterations and the degree to which body systems affected, a deeper knowledge of the impact of movement (maladaptive and healthy) could aid medical teams, exercise professionals and patients. It is of great importance, therefore, to look at EDs from a more complex perspective that includes the biophysiological component. This talk will provide an overview of the main neurobiological alterations in EDs. Following, we will offer a comprehensive view of the bio-physiology and body systems affected on these disorders including areas of interest such as muscle, fat and bone tissue, microbiota, epigenetics, or inflammation. In addition, this talk will also seek to clarify the connections between the biophysiological alterations and the modulatory potential of healthy movement in EDs.
Speaker B
Bratland-Sanda Solfrid
University of South-Eastern Norway, Department of sport, physical education and outdoor studies
Norway
Read CVECSS Glasgow 2024: IS-MH08
Compulsive exercise: understanding exercise obsessions and compulsions
Difficult relationships with movement have long plagued the field of eating disorders (EDs). Starting in the 19th century, clinicians and researchers have documented such behavior in their patients and attempted to term this phenomenon and determine a corresponding conceptualization. Unfortunately, a consensus has yet to be reached on how to conceptualize difficult relationships with movement. In part, this is due to the lack of knowledge and understanding about both the complexity cognitions and behaviors. Recent advancements have identified exercise obsessions without compulsions across various population, making the cognitions about exercise relevant also for the sedentary persons. This adds to the complexity of how to identify and manage complicated relationships with movement across populations (i.e., athletes, persons diagnosed with EDs or persons experiencing disordered eating). This is of particular importance because up to 80% of patients engage in maladaptive movement over the course of their EDs. Further yet, individuals with and without EDs can experience facets of maladaptive movement. In this presentation, we will give an update on recent advancements in the conceptualization of compulsive exercise and present the term “maladaptive (bodily) movement”, which reflects both quantitative and qualitative aspects. We will also explore their presentation across populations and activity types (i.e., incidental physical activity, exercise, and sports). Finally, we will outline how the qualitative facets of maladaptive movement can present in the non-ED population and present the implications for the general population. Together, this presentation will offer knowledge on different aspects and conceptualizations of maladaptive movement. It will provide information on the tools and instruments used to identify and manage such behavior in both athletic and clinical populations.
Speaker C
Danika Quesnel
University of Toronto, Department of Psychological Clinical Sciences
Canada
Read CVECSS Glasgow 2024: IS-MH08
The Safe Exercise at Every Stage (SEES) Guideline, Updates, and Implementation
Eating disorders (EDs) are a group of mental health disorders that cause serious harm to both physical and psychological health and well-being. Although treatment advancements have been made, ED outcomes are often less than ideal as high levels of drop-out, partial responses to available therapies, and elevated relapse rates characterize ED patients. A factor that has been known to interfere with ED treatment and recovery is maladaptive movement, which reflects quantitative and qualitative features of one’s relationship with activity across modalities (i.e., incidental activity, sport, exercise). Engaging in maladaptive movement before, during and after ED treatment can aggravate negative treatment outcomes. However, clinicians don’t feel they have the knowledge and tools to address this transdiagnostic ED symptom. Further complicating this arena is the incidence of EDs and maladaptive movement in athlete populations. For athletes, their careers, financial wellbeing, education, and identity often rely on their ability to perform in the sport. However, the incidence of an ED and maladaptive movement can make sports engagement difficult, if not impossible, for some. It leaves coaches and clinicians with the difficult task of helping athletes return to their sport if achievable. The Safe Exercise at Every Stage (SEES) and Safe Exercise at Every Stage- Athlete (SEES-A) guidelines were developed to support clinicians and exercise professionals in managing movement during treatment for an eating disorder. Since 2019, the SEES guidelines have garnered international recognition and helped private and public ED treatment programs enhance how they address movement with their clients. Clinician training based on the SEES guideline demonstrated the ability to improve clinician self-efficacy in addressing maladaptive movement during treatment. The SEES team has continued to remain up to date with the current literature and integrated it into the SEES and SEES-A guidelines. This talk will provide an overview of the SEES and SEES-A guideline and how they have been updated over the last five years. We will continue by guiding health professionals through step-by-step instruction on using the guidelines in clinical practice with athletes and the general population. Finally, an open discussion will engage participants in reviewing any questions or difficulties they have had in navigating maladaptive movement in EDs within research and clinical contexts.