Physiotherapy improves eating disorders and quality of life in bulimia and anorexia nervosa.

BACKGROUND Bulimia and anorexia nervosa are the main diagnostic categories of eating disorders, affecting up to 1.5% of people in the USA at any one time. Both conditions are associated with physical (eg, reduced body mass index, percentage of body fat) and psychosocial (eg, depression, anxiety, quality of life) impairments, as well as high risk of death. Anorexia nervosa is specifically characterised by an excessive exercise engagement with fear of weight gain and aversion of fat, whereas people with bulimia nervosa present with binge eating and purging. These eating disorders are considered one of the most challenging psychiatric conditions to treat, and treatment usually comprises of cognitive–behavioural therapy and pharmacological management. 7 Exercise is usually not recommended for patients with these conditions, mainly due to the belief that it might aggravate the progress of the disorder. However, there is evidence that exercise increases body mass index and reduce depression in people with binge eating. What is uncertain is whether physiotherapy interventions are effective in treating bulimia and anorexia nervosa.