The role of exercise across the lifespan in patients with anorexia nervosa : a narrative inquiry

The current study explored the role of exercise across the lifespan in patients with anorexia nervosa (AN). Twenty-four female participants were recruited: 10 currently in treatment for AN, 7 partially recovered and 7 fully recovered, according to stringent criteria. Participants completed the eating disorder examination (EDE) and a semi-structured interview where they were invited to share their story of their illness, with a specific focus on exercise. A qualitative analysis using narrative inquiry methodology was conducted. We found that exercise can be a significant part of the individual's life in various stages" premorbidly, and in treatment and recovery processes. Important themes across stages included: rapid transformation into compulsive exercise during AN; importance of containment processes during treatment; appropriate limit setting and accountability in early stages of recovery; and the gradual transformation into healthy exercise in full recovery. Results were developed into a model of exercise depicting these themes. Clinical implications to support reintegrating healthy exercise include the use of psycho-education and structured exercise interventions, working within consistent clinical guidelines for exercise in treatment. Ongoing interpersonal and therapeutic support is also required for patients to re-establish healthy exercise as part of a whole balanced life in recovery.