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Physiotherapy improves eating disorders and quality of life in bulimia and anorexia nervosa
  1. Gustavo C Machado,
  2. Manuela L Ferreira
  1. The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Gustavo C Machado, Musculoskeletal Division, The George Institute for Global Health, PO Box M201, Missenden Road, NSW 2050 Australia; gmachado{at}

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This section features a recent systematic review that is indexed on PEDro, the Physiotherapy Evidence Database ( PEDro is a free, web-based database of evidence relevant to physiotherapy.

▸ Vancampfort D, Vanderlinden J, de Hert M, et al. A systematic review of physical therapy interventions for patients with anorexia and bulimia nervosa. Disabil Rehabil 2014;36:628–34.


Bulimia and anorexia nervosa are the main diagnostic categories of eating disorders,1 affecting up to 1.5% of people in the USA at any one time.2 Both conditions are associated with physical (eg, reduced body mass index, percentage of body fat) and psychosocial (eg, depression, anxiety, quality of life) impairments,3 as well as high risk of death.4 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,5 and treatment usually comprises of cognitive–behavioural therapy and pharmacological management.6 ,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.1 However, there is evidence that exercise increases body mass index and reduce depression in people with binge eating.8 What is uncertain is whether physiotherapy interventions are effective in treating bulimia and anorexia nervosa.


The aim of this systematic review was to investigate the effectiveness of physiotherapy interventions versus usual care or waitlist in patients with anorexia and bulimia nervosa. …

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  • Contributors GCM wrote the first draft of the manuscript. GCM and MLF interpreted the systematic review, contributed to interpretation of the data and revision of the final version of the manuscript and both are guarantors.

  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.