Strength and Power Improvements in Athlete and Non-Athletes During Intensive Eating Disorder Treatment

in Journal of Clinical Sport Psychology
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  • 1 University of Missouri-St. Louis
  • | 2 McCallum Place Eating Disorder Treatment Centers
  • | 3 University of Louisville
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Understanding the unique needs of athletes who undergo eating disorder (ED) treatment is sorely needed. This study explores changes of strength and power in athlete (n = 21) and non-athlete (n = 36) patients from intake to discharge. Maximal oxygen consumption, vertical jump, push-ups, hand grip strength, and body mass index (in anorexia nervosa; AN) were measured among treatment center patients. The number of push-ups and hand grip strength were significantly improved upon discharge in the full sample (ps < .005) and in AN only (ps < .001). Body mass index was also significantly higher in AN (p < .001). Maximal oxygen consumption and vertical jump did not significantly improve between admission and discharge in either group (ps > .40). This study is the first to investigate measures of strength in athletes engaged in intensive eating disorder treatment and indicates the need to address the psychological mindset around physical activity using exercise education as part of a comprehensive program. Recommendations for incorporating exercise into an intensive ED treatment center are also provided.

Fewell is with the Dept. of Psychological Sciences at University of Missouri-St. Louis. Nickols and Schlitzer Tierney are with The Victory Program, McCallum Place Eating Disorder Treatment Centers, St. Louis, MO. Levinson is with the Dept. of Psychological and Brain Sciences at University of Louisville, Louisville, KW.

Address author correspondence to Cheri A. Levinson at cheri.levinson@louisville.edu.
  • Academy of Eating Disorders. (n.d.). Position Statement: AED Emphasizes Physical Health more than BMI. Retrieved from http://www.aedweb.org/web/index.php/23-get-involved/position-statements/158-aed-emphasizes-physical-health-more-than-bmi

    • Search Google Scholar
    • Export Citation
  • Arthur-Cameselle, J.N., & Quatromoni, P.A. (2014). Eating disorders in collegiate female athletes: Factors that assist recovery. Eating Disorders: The Journal of Treatment and Prevention, 22, 5061. doi:10.1080/10640266.2014.857518

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Baechle, T., & Earle, R. (2008). Essentials of strength training and conditioning, 3, 94.

  • Bar, R.J, Cassin, S.E., & Dionne, M.M. (2016). Eating disorder prevention initiatives for athletes: A review. European Journal of Sport Science, 16(3), 325335. 25815432 doi:10.1080/17461391.2015.1013995

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Baum, A. (2006). Eating disorders in the male athlete. Sports Medicine, 36(1), 16. 16445307 doi:10.2165/00007256-200636010-00001

  • Becker, C.B., McDaniel, L., Bull, S., Powell, M., & McIntyre, K. (2012). Can we reduce eating disorder risk factors in female college athletes? A randomized exploratory investigation of two peer-led interventions. Body Image, 9(1), 3142. 22019502 doi:10.1016/j.bodyim.2011.09.005

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Beumont, P.J.V., Arthur, B., Russell, J.D., & Touyz, S.W. (1994). Excessive exercise in dieting disorder patients: Proposals for a supervised exercise program. International Journal of Eating Disorders, 15, 2136. doi:10.1002/1098-108X(199401)15:1<21::AID-EAT2260150104>3.0.CO;2-K

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bompa, T. (1983). Theory and methodology of training: The key to athletic performance. Toronto, Canada: Human Kinetics.

  • Calogero, R.M., & Pedrotty, K.N. (2004). The practice and process of healthy exercise: An investigation of the treatment of exercise abuse in women with eating disorders. Eating Disorders: The Journal of Treatment and Prevention, 12(4), 273291. doi:10.1080/10640260490521352

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Carei, T.R., Fyfe-Johnson, A.L., Breuner, C.C., & Brown, M.A. (2010). Randomized controlled clinical trial of yoga in the treatment of eating disorders. Journal of Adolescent Health, 46(4), 346351. 20307823 doi:10.1016/j.jadohealth.2009.08.007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Carter, J.C., Blackmore, E., Sutander-Pinnock, K., & Woodside, D.B. (2004). Relapse in anorexia nervosa: A survival analysis. Psychological Medicine, 34, 671679. 15099421 doi:10.1017/S0033291703001168

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chantler, I., Szabo, C.P., & Green, K. (2006). Muscular strength changes in hospitalized anorexic patients after an eight week resistance training program. International Journal of Sports Medicine, 27, 660665. 16874594 doi:10.1055/s-2005-865812

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cook, B.J., Wonderlich, S.A., Mitchell, J.E., Thompson, R., Sherman, R., & McCallum, K. (2016). Exercise in eating disorders treatment: Systematic review and proposal of guidelines. Medicine & Science in Sports & Exercise, 48, 14081414. 26909533 doi:10.1249/MSS.0000000000000912

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Davis, C., Katzman, D.K., Kaptein, S., Kirsh, C., Brewer, H., Kalmbach, K., . . . Kaplan, AS. (1997). The prevalence of high-level exercise in the eating disorders: Etiological implications. Comprehensive Psychiatry, 38, 321326. 9406737 doi:10.1016/S0010-440X(97)90927-5

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Davis, C., Katzman, D.K., & Kirsh, C. (1999). Compulsive exercise in adolescents with anorexia nervosa: A psychobehavioral spiral of pathology. Journal of Nervous and Mental Disease, 187, 336342. 10379720 doi:10.1097/00005053-199906000-00002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • del Valle, M.F., Pérez, M., Santana-Sosa, E., Fiuza-Luces, C., Bustamante-Ara, N., Gallardo, C., . . . Lucía, A. (2010). Does resistance training improve the functional capacity and well being of very young anorexic patients? A randomized controlled trial. Journal of Adolescent Health, 46(4), 352358. 20307824 doi:10.1016/j.jadohealth.2009.09.001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fernandez-del-Valle, M., Larumbe-Zabala, E., Villaseñor-Montarroso, A., Cardona Gonzalez, C., Diez-Vega, I., Lopez Mojares, L.M., & Perez Ruiz, M. (2014). Resistance training enhances muscular performance in patients with anorexia nervosa: A randomized controlled trial. International Journal of Eating Disorders, 47(6), 601609. 24810684 doi:10.1002/eat.22251

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fewell, L.K., Levinson, C.A., & Stark, S. (2017). Depression, worry, and psychosocial functioning predict eating disorder treatment outcomes in a residential and partial hospitalization setting. Eating and Weight Disorders, Studies on Anorexia, Bulimia, and Obesity, 4(4), 111. doi:10.1007/s40519-016-0357-6

    • Search Google Scholar
    • Export Citation
  • Fewell, L.K., Nickols, R., Schlitzer Tierney, A., & Levinson, C.A. (2018). Eating disorders in sport: Comparing athletes to non-athletes at an intensive eating disorder treatment center. Manuscript submitted for publication.

    • Search Google Scholar
    • Export Citation
  • Greenleaf, C., Petrie, T.A., Carter, J., & Reel, J.J. (2009). Female collegiate athletes: Prevalence of eating disorders and disordered eating behaviors. Journal of American College Health, 57(5), 489495. 19254889 doi:10.3200/JACH.57.5.489-496

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Harris, E.C., & Barraclough, B. (1998). Excess mortality of mental disorder. British Journal of Psychiatry, 173(1), 1153. doi:10.1192/bjp.173.1.11

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Joy, E., De Souza, M.J., Nattiv, A., Misra, M., Williams, N., Mallinson, R.J., . . . Expert Panel. (2014). Female athlete triad coalition consensus statement on treatment and return to play of the female athlete triad: 1st International Conference held in San Francisco, California, May 2012 and 2nd International Conference held in Indianapolis, Indiana, May 2013. British Journal of Sports Medicine, 48(4), 289. doi:10.1136/bjsports-2013-093389

    • Search Google Scholar
    • Export Citation
  • Joy, E., Kussman, A., & Nattiv, A. (2016). 2016 update on eating disorders in athletes: A comprehensive narrative review with a focus on clinical assessment and management. British Journal of Sports Medicine, 50, 154162. 26782763 doi:10.1136/bjsports-2015-095735

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Just Jump. (2015). Retrieved from http://www.power-systems.com/p-3839-just-jump.aspx

  • Katz, J. (1996). Clinical observations on the exercise of anorexia nervosa. In W.F. Epling & W.D. Pierce (Eds.), Activity anorexia: Theory, research, and treatment (pp. 199207). Mahwah, NJ: Lawrence Erlbaum.

    • Search Google Scholar
    • Export Citation
  • Martinsen, M., Bahr, R., Børresen, R., Holme, I., Pensgaard, A.M., & Sundgot-Borgen, J. (2014). Preventing eating disorders among young elite athletes: A randomized controlled trial. Medicine & Science in Sports & Exercise, 46, 435447. 24549033 doi:10.1249/MSS.0b013e3182a702fc

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Moola, F.J., Gairdner, S.E., & Amara, C.E. (2013). Exercise in the care of patients with anorexia nervosa: a systematic review of the literature. Mental Health and Physical Activity, 6(2), 5968.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, S., Constantini, N., Lebrun, C., . . . Ljungqvist, A. (2014). The IOC consensus statement: Beyond the female athlete triad—Relative energy deficiency in sport (RED-S). British Journal of Sports Medicine, 48, 491497. 24620037 doi:10.1136/bjsports-2014-093502

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Olmsted, M.P., Woodside, D.B., Carter, J.C., McFarlane, T.L., Staab, R., Colton, P.A., & Molleken, L.L. (2007). Intensive treatments for eating disorders. In G.O. Gabbard (Ed.), Treatments of psychiatric disorders (4th ed., pp. 709722). Washington, DC: American Psychiatric Press.

    • Search Google Scholar
    • Export Citation
  • Plateau, C.R., Arcelus, J., Leung, N., & Meyer, C. (2017). Female athlete experiences of seeking and receiving treatment for an eating disorder. Eating disorders, 25(3), 273277. 28051927 doi:10.1080/10640266.2016.1269551

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Reel, J.J. (2015). The relationship between exercise and eating disorders: A double-edged sword. In M.B. Andersen & S.J. Hanrahan (Eds.), Doing exercise psychology. Champaign, IL: Human Kinetics.

    • Search Google Scholar
    • Export Citation
  • Reel, J.J., Galli, N., Miyairi, M., Voelker, D., & Greenleaf, C. (2016). Development and validation of the intuitive exercise scale. Eating Behaviors, 22, 129132. 27289049 doi:10.1016/j.eatbeh.2016.06.013

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Reel, J.J., & Voelker, D. (2012). Exercise to the extreme? Identifying and addressing unhealthy exercise behaviors. In R. Schinke (Ed.), Athletic Insight’s writings of 2012 (pp. 301315). Hauppauge, NY: Nova Science.

    • Search Google Scholar
    • Export Citation
  • Sherman, K.J., Cherkin, D.C., Erro, J., Miglioretti, D.L., & Deyo, R.A. (2005). Comparing yoga, exercise, and a self-care book for chronic low back pain. Annals of Internal Medicine, 143, 849856. 16365466 doi:10.7326/0003-4819-143-12-200512200-00003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sherman, R.T., & Thompson, R.A. (2001). Athletes and disordered eating: Four major issues for the professional psychologist. Professional Psychology—Research & Practice, 32(1), 2733. 29684829 doi:10.1037/0735-7028.32.1.27

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Strength Training. (n.d.). Retrieved from https://www.chponline.com/store/cart.php

  • Sundgot-Borgen, J. (1993). Prevalence of eating disorders in elite female athletes. International Journal of Sport Nutrition, 3(1), 2940. 8499936 doi:10.1123/ijsn.3.1.29

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sundgot-Borgen, J., Rosenvinge, J.H., Bahr, R., & Schneider, L.S. (2002). The effect of exercise, cognitive therapy, and nutritional counseling in treating bulimia nervosa. Medicine & Science in Sports & Exercise, 34(2), 190195. 11828224 doi:10.1097/00005768-200202000-00002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sundgot-Borgen, J., & Torstveit, M.K. (2004). Prevalence of eating disorders in elite athletes is higher than in the general population. Clinical Journal of Sport Medicine, 14(1), 2532. 14712163 doi:10.1097/00042752-200401000-00005

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Taranis, L., & Meyer, C. (2011). Associations between specific components of compulsive exercise and eating-disordered cognitions and behaviors among young women. International Journal of Eating Disorders, 44, 452458. 20721896 doi:10.1002/eat.20838

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Torres-McGehee, T.M., Green, J.M., Leaver-Dunn, D., Leeper, J.D., Bishop, P.A., & Richardson, M.T. (2011). Attitude and knowledge changes in collegiate dancers following a short-term, team-centred prevention program on eating disorders. Perceptual and Motor skills, 112, 711725. 21853760 doi:10.2466/06.PMS.112.3.711-725

    • Crossref
    • Search Google Scholar
    • Export Citation
  • VO2 Max Testing. (2017). Retrieved from https://med.virginia.edu/exercise-physiology-core-laboratory/fitness-assessment-for-community-members-2/vo2-max-testing/

    • Search Google Scholar
    • Export Citation
  • Yahalom, M., Spitz, M., Sandler, L., Heno, N., Roguin, N., & Turgeman, Y. (2013). The significance of bradycardia in anorexia nervosa. International Journal of Angiology, 22(2), 8394. 24436590 doi:10.1055/s-0033-1334138

    • Crossref
    • Search Google Scholar
    • Export Citation
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