It’s not all about the weight!
PhD project indicates the importance of exercise to regulate mood and emotions in patients with eating disorders. Despite a higher amount of weekly physical activity among the patients compared to the controls, the study did not detect differences in physical fitness.
Karen Christensen | 03.06.2010 
Aim of the dissertation
The aim of the dissertation was to examine different aspects of physical activity and physical fitness among female inpatients with longstanding eating disorders compared to non-clinical age- and sex-matched controls.
Furthermore, changes in physical activity in correlation with changes in eating disorders severity during the treatment period were described among the patients.
Patients from Modum Bad
59 patients and 53 controls participated in the study. The patients were hospitalized at department of eating disorders, Modum Bad. The controls were randomly selected from a database of Norwegian women with similar age as the patients. Mean age among the patients was 30.1 years (SD 8.5 years), and they had a mean illness duration of 14.3 years (SD 8.0 years).
The study was carried out as a two-phase study, where phase 1 was a cross sectional study including both patients and controls. This phase was conducted upon admission for the patients, and these data served as baseline for phase 2 of the study. The second phase was a follow up of the patients from admission to discharge.
Patients under report amount of physical activity
The patients were more physically active compared to the controls. Compared to objectively assessed physical activity, the patients underreported weekly amount of physical activity by 14 %. This shows the importance of proper screening of the patients’ physical activity level upon admission.
Importance of exercise to regulate mood and emotions – it’s not all about the weight!
The patients perceived exercise for regulation of feelings as more important than the controls. Furthermore, the excessive exercising patients perceived exercise for regulation of feelings as a more important reason than the non-excessive exercising patients. No differences between patients and controls, or excessive and non-excessive exercising patients, were found with respect to importance of exercising for regulation of body weight.
This can indicate that exercise to regulate body weight is important for females in general, independent of whether they have or do not have an eating disorder and independent of how much they actually exercise. A high correlation between reduced importance of exercise for regulation of feelings, not regulation of weight, and reduced severity of the eating disorder was also detected among the patients from admission to discharge.
Associations between physical fitness, physical activity and bone health
Despite a higher amount of weekly physical activity among the patients compared to the controls, we did not detect differences in physical fitness (aerobic capacity and muscular strength). This is probably due to nutritional status among the patients, and that several of the patients display possible overtraining syndrome.
Among the patients, only muscular strength and high mechanical loading physical activity, not weight bearing physical activity in general, was associated with bone mineral density. 37 % of the variance in bone mineral density was explained by a history of anorexia and muscle strength. This implies that weight bearing physical activity in general is not enough to counteract the adverse effects of eating disorders upon bone health.
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Solfrid Bratland-Sanda (16.10.1980) ) is born in Vinje, Telemark. She obtained her Bachelors degree in physical activity and health from Telemark University College and NSSS. She completed her Master’s degree with major in physical activity and health and exercise physiology from NSSS in 2005. Solfrid started as a PhD candidate at Modum Bad in September 2005 and the project has been done in |
cooperation between Modum Bad and NSSS. Supervisors have been Professor Jorunn Sundgot-Borgen (NSSS) and Professor Egil W. Martinsen (Oslo University Hospital / University of Oslo).
Evaluation committee
Leader: Professor Sigmund A. Anderssen, Norwegian School of Sport Sciences
1. Opponent: Professor Ingemar Engström, University of Örebro, Örebro, Sweden
2. Opponent: Division director Wenche Nystad, Norwegian Institute of Public Health, Oslo, Norway
Programme
10.15 – 11.00 Trial lecture: "Exercise dependence”: begrep, diagnostikk og betydning i forhold til spiseforstyrrelser.
13.00 – 16.00 Dissertation
Both the trial lecture and the dissertation are open for the audience.